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Pre‐cessation nicotine replacement therapy: pragmatic randomized trial
Author(s) -
Bullen Chris,
Howe Colin,
Lin RueyBin,
Grigg Michele,
Laugesen Murray,
McRobbie Hayden,
Glover Marewa,
Walker Natalie,
WallaceBell Mark,
Whittaker Robyn,
Rodgers Anthony
Publication year - 2010
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2010.02989.x
Subject(s) - quitline , smoking cessation , medicine , nicotine replacement therapy , abstinence , randomized controlled trial , nicotine gum , cotinine , nicotine withdrawal , adverse effect , nicotine patch , nicotine , physical therapy , psychiatry , placebo , alternative medicine , pathology
Aims To determine the effectiveness of 2 weeks' pre‐cessation nicotine patches and/or gum on smoking abstinence at 6 months. Design Pragmatic randomized controlled trial. Setting New Zealand. Participants Eleven hundred adult, dependent smokers who called the New Zealand Quitline between March 2006 and May 2007 for support to stop smoking were randomized to 2 weeks of nicotine patches and/or gum prior to their target quit day followed by usual care (8 weeks of patches and/or gum plus support calls from a Quitline adviser), or to usual care alone. Measurements The primary outcome was self‐reported 7‐day point prevalence smoking abstinence 6 months after quit day. Secondary outcomes included continuous abstinence, cotinine‐verified abstinence, daily cigarette consumption, withdrawal symptoms and adverse events. Findings Six months after quit day 125 (22.7%) participants in the pre‐cessation group and 116 (21.0%) in the control group reported 7‐day point prevalence abstinence (relative risk 1.08 95% CI: 0.86, 1.35, P = 0.4, risk difference 1.7%, 95% CI: −3.2%, 6.6%). However, when pooled in a meta‐analysis with other pre‐cessation trials a moderate benefit of about a one‐quarter increase in cessation rates was evident. There was no difference in adverse events between groups. Conclusions In this, the largest pre‐cessation NRT trial to date, using NRT 2 weeks before the target quit day was safe and well tolerated but offered no benefit over usual care. However, in conjunction with previous pre‐cessation trials there appears to be a moderate benefit, but not as large as that seen in most smaller trials.