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Quitting chew: results from a randomized trial using nicotine patches
B Howard-Pitney1, J D Killen, S P Fortmann
1Stanford University School of Medicine, California, USA. howard@SCRDP.Stanford.edu
Experimental and Clinical Psychopharmacology
|December 28, 1999
Summary
Transdermal nicotine patches combined with behavioral therapy showed promising results for chewing tobacco cessation. While initial abstinence rates were similar, the nicotine patch significantly reduced relapse rates at six months.
Area of Science:
- Addiction Medicine
- Behavioral Psychology
- Pharmacology
Background:
- Chewing tobacco is a significant public health concern.
- Nicotine dependence from chewing tobacco presents unique cessation challenges.
- Effective interventions for chewing tobacco cessation are needed.
Purpose of the Study:
- To evaluate the efficacy of transdermal nicotine replacement therapy (NRT) in conjunction with behavioral treatment for chewing tobacco cessation.
- To compare relapse rates between users receiving active nicotine patches and those receiving placebo patches.
Main Methods:
- A randomized controlled trial involving 410 adult nonsmoking chewing tobacco users.
- Participants received either a 15-mg nicotine patch or a placebo patch for 6 weeks, alongside standardized behavioral support.
- Biochemical confirmation was used to verify abstinence at 6-month follow-up.
Main Results:
- Point-prevalence abstinence rates at 6 months were high and not significantly different between the active (38%) and placebo (34%) groups.
- The active nicotine patch group demonstrated a significantly lower relapse rate (33%) compared to the placebo group (48%) at 6 months (p = .003).
- Higher nicotine dependence and older age were predictors of sustained non-relapse.
Conclusions:
- Transdermal nicotine replacement therapy, when combined with behavioral treatment, may enhance long-term abstinence from chewing tobacco.
- Nicotine patches appear to be particularly effective in preventing relapse among former chewing tobacco users.
- Further research into NRT efficacy for smokeless tobacco cessation is warranted.