[Individual treatment of smoking addiction. Results using 2 and 4 mg nicotine gum]

We present the results of an open follow-up study aimed at analyzing the efficacy of combining psychological counseling with prescription of 2 and 4 mg nicotine gum to treat smokers. Two groups of smokers wer studied. Group A contained 124 subjects (74 men, 50 women) with a mean age of 37.4 (15.3) yr who were smokers of 15.3 (8.7) cigarettes/day. In this group physical addiction to nicotine was low, assessed as 1.7 (1.3) on the Fagerström test. Group B consisted of 107 subjects (61 men, 46 women) with a mean age of 38.9 (14.6) who were smokers of 26.9 (9.3) cigarettes/day and whose level of physical addiction to nicotine was moderate-to-high, assessed as 6.1 (2.4) on the Fagerström test. Standard deviations are shown between parentheses. Both groups were given minimal psychological counseling; additionally, patients were prescribed one piece of nicotine gum very 90 to 120 minutes during waking hours (2 mg in group A and 4 mg in group B). The dose was gradually reduced after the sixth to the eight week. The subjects were seen eight times over the first year (first day of consultation and during the first, second, fourth, eight and twelfth weeks after quitting, and again after six and twelve months). After twelve weeks of follow-up, sixty-one subjects (49%) in group A and 50 (47%) in group B were still abstinent. These proportions fell to 56 (45%) and 46 (43%), respectively, after one year of follow-up. Eighty-one percent of group A patients who were successful after three months of follow-up, and 87% of the successful group B patients, had used the nicotine gum as prescribed. Oropharyngeal, dental, and temporo-mandibular joint symptoms, hiccoughins, flatulence and heartburn were the most frequent side effects (ranging from 3% to 18%). Side effects were always slight and were not detected after the eighth week of treatment. In conclusion, combined therapy (minimal psychological counseling plus use of 2 or 4 mg nicotine gum depending on the level of physical addiction) yields a success rate between 43% and 45% still abstaining after one year of follow-up. Side effects are few and mild.