Related Experiment Video
Updated: Jan 23, 2026

Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
Factors Associated with Adherence to Transdermal Nicotine Patches within a Smoking Cessation Effectiveness Trial
Jonnie Handschin1, Brian Hitsman2, Sonja Blazekovic1
1Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104.
Background:
Adherence to transdermal nicotine patches, one of the most popular and effective treatment for nicotine dependence, remains very low and is a strong predictor of cessation rates. This study examined individual factors related to adherence as well as differences over time between adherent (≥ 80% of daily patch use) and non-adherent participants (< 80% of daily patch use).
Methods:
We analyzed data from 440 participants who received 8 weeks of 21mg transdermal nicotine and 4 behavioral counseling sessions within an effectiveness trial that examined the effects of long-term treatment. Multiple logistical regression assessed baseline variables associated with patch adherence and generalized estimating equations (GEE) were used to evaluate changes in craving and withdrawal, depressive and anxiety symptoms, substitute and complementary reinforcers, and side effects between participants who were or were not adherent.
Results:
In a logistic regression model, being female, living with a child or children, and higher self-reported anxiety symptoms were predictive of lower patch adherence (p < .05). In the GEE analysis, adherence was significantly associated with: a greater reduction in craving, a greater engagement in substitute reinforcers, and a greater decrease in complementary reinforcers over time (p < .05).
Conclusions:
Difficulties adhering to transdermal nicotine patches may be related to psychiatric comorbidity, difficulty managing nicotine craving, and challenges with engaging in substitute reinforcers and reducing exposure to complementary reinforcers. These constructs may serve as targets for interventions designed to increase treatment adherence.
More Related Videos
Related Concept Videos
Cholinergic Receptors: Nicotinic
There are two types of nicotinic receptors: neuromuscular (NM/NM/N1) and neuronal (NN/NN/N2). The two families differ based on their location and selectivity to...
Long-patch Base Excision Repair
CNS Depressants: Alcohol and Nicotine
Factors Affecting Dissolution: Particle Size and Effective Surface Area
Clinical Trials
There are four phases in a clinical trial. A phase one...
Clinical Trials: Overview

