Nicotine gum and psychological support in smoking cessation. A pilot study in South Africa

The effectiveness of freely chosen, personally paid-for, 2 mg nicotine gum (Nicorette; MPS Laboratories) as an adjunct to group psychological support in 12 heavy smokers motivated to stop was compared with 11 matched controls who chose not to use gum and received psychological support only. After 6 months, 50% of the group using gum had stopped smoking compared with 27% of the controls (verified by the measurement of carboxyhaemoglobin concentrations). There was a tendency to underuse gum despite careful instructions in its use, but surprisingly there was a significant negative correlation between the amount of gum used and stopping smoking. It is suggested that this may have been a function of the nature of the psychological support, which was highly structured to fade nicotine and build up a repertoire of alternate behaviours before stopping. In view of the tendency to underuse the gum, general practitioners prescribing nicotine gum without psychological support should ensure that sufficient gum is used for it to function as a pharmacologial aid.