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Can we increase smokers' adherence to nicotine replacement therapy and does this help them quit?
Tanya R Schlam1, Jessica W Cook2,3,4, Timothy B Baker2,3
1Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1930 Monroe Street, Suite 200, Madison, WI, 53711, USA. trschlam@ctri.wisc.edu.
Psychopharmacology
|April 27, 2018
Summary
Electronic monitoring counseling increased nicotine gum use but not smoking abstinence. However, higher adherence to both nicotine patch and gum was linked to greater long-term smoking cessation success.
Area of Science:
- Addiction research
- Behavioral science
- Clinical pharmacology
Background:
- Smoking cessation remains a significant public health challenge.
- Combined nicotine replacement therapy (NRT) like patch and gum is a common strategy.
- Optimizing adherence to NRT is crucial for successful quitting.
Purpose of the Study:
- To evaluate five intervention components aimed at improving adherence to combined nicotine patch and gum therapy.
- To determine the relationship between adherence to NRT and smoking cessation outcomes.
Main Methods:
- A large randomized factorial experiment involving 513 smokers undergoing a quit attempt.
- Interventions included medication adherence counseling, automated calls, electronic monitoring, duration of NRT, and maintenance counseling.
- Adherence was measured using timeline follow-back for patches and electronic dispensers for gum over the first six weeks post-quit.
Main Results:
- Only 1.4% of participants achieved daily adherence to both nicotine patch and gum over six weeks.
- Electronic monitoring counseling increased daily gum piece usage (1.9 to 2.6 pieces/day) but did not significantly improve abstinence rates.
- Higher adherence to both nicotine patch and nicotine gum individually was associated with increased point-prevalence abstinence rates up to one year.
Conclusions:
- Electronic monitoring with counseling enhances nicotine gum usage but does not directly increase smoking abstinence.
- Strong associations exist between adherence to nicotine patch and gum and successful smoking cessation.
- Further research is needed to clarify the causal relationship between NRT adherence and sustained abstinence.