Delivery of a one-week chewing gum for promoting smoking cessation: A pilot randomized controlled trial

Chewing gum has been used as a self-help strategy for managing smoking cravings, yet its effectiveness has not been evaluated. This pilot trial assessed the feasibility, acceptability, and preliminary effectiveness of delivering 1-week chewing gum for promoting quitting.

Adult daily smokers were recruited from smoking hotspots in Hong Kong in February 2025. All participants received very brief advice (VBA) and a selfhelp booklet at baseline. The intervention group additionally received 1 week of chewing gum (2 packs) and 2 weeks of instant messaging reminders to promote gum usage, whereas the control group received no placebo or sham intervention beyond VBA and the booklet. Follow-up was conducted at 2 weeks, 3 months, and 6 months post-enrolment. The primary outcome was biochemically validated tobacco abstinence at 6 months. Risk ratios (RRs) were used to estimate the intervention effect using intention-to-treat analysis in Poisson regression.

The recruitment rate was 91%, and the retention rate was 86%, 78%, and 74% at 2 weeks, 3 months, and 6 months, respectively. Eighty participants were randomly assigned to the intervention (n=40) and control (n=40) groups using a 1:1 allocation ratio. The intervention group had a higher validated abstinence (10% vs 0%; risk difference, RD=0.53; 95% CI: 0.41-0.64) at 6 months than the control group. Among intervention group participants, 75% (30/40) used chewing gum, and 57% (17/30) rated it as helpful in relieving cravings. Those who used the chewing gum had higher rates of quit attempts (77% vs 40%, p=0.03) and smoking reduction (73% vs 40%, p=0.06) than those who did not.

Delivering chewing gum was feasible and showed preliminary evidence of effectiveness in cessation outcomes. Full trials with an extended intervention period are warranted.

The study is registered on the official website of ClinicalTrials.gov.

CT06801860.