Stuart G Ferguson1, Saul Shiffman. 1. School of Pharmacy and Menzies Research Institute,University of Tasmania, Hobart, Tasmania 7001, Australia. stuart.ferguson@utas.edu.au
Abstract
OBJECTIVE:Nicotine patch improves treatment outcomes, but lapses are still common. To understand the process of relapse on patch, we investigated differences in the antecedents (withdrawal, setting, triggers) of lapse episodes experienced on high-dose (35 mg) nicotine patches versus placebo. DESIGN:Participants were smokers who lapsed during a randomized, double-blind trial of active patches (n = 100) versus placebo (n = 85). Participants used electronic diaries to monitor their smoking, affect, and activities in real time for 5 weeks during their cessation attempt. RESULTS: We analyzed 490 lapse episodes (active: 266; placebo: 224). Lapses on nicotine patch were characterized by significantly lower positive affect and higher negative affect than placebo lapses. Participants treated with high-dose patch were also significantly more likely to lapse in situations involving little or no craving. Situational antecedents of lapses on patch resembled those on placebo. CONCLUSION: The results suggest that treatment with patch may set a higher threshold for affective stimuli to provoke lapses, but does not change the proximal cues that trigger lapses. This suggests that behavioral relapse-prevention strategies developed for unmedicated smokers should also apply to those treated with nicotine patch. PsycINFO Database Record (c) 2010 APA, all rights reserved
RCT Entities:
OBJECTIVE:Nicotine patch improves treatment outcomes, but lapses are still common. To understand the process of relapse on patch, we investigated differences in the antecedents (withdrawal, setting, triggers) of lapse episodes experienced on high-dose (35 mg) nicotine patches versus placebo. DESIGN:Participants were smokers who lapsed during a randomized, double-blind trial of active patches (n = 100) versus placebo (n = 85). Participants used electronic diaries to monitor their smoking, affect, and activities in real time for 5 weeks during their cessation attempt. RESULTS: We analyzed 490 lapse episodes (active: 266; placebo: 224). Lapses on nicotine patch were characterized by significantly lower positive affect and higher negative affect than placebo lapses. Participants treated with high-dose patch were also significantly more likely to lapse in situations involving little or no craving. Situational antecedents of lapses on patch resembled those on placebo. CONCLUSION: The results suggest that treatment with patch may set a higher threshold for affective stimuli to provoke lapses, but does not change the proximal cues that trigger lapses. This suggests that behavioral relapse-prevention strategies developed for unmedicated smokers should also apply to those treated with nicotine patch. PsycINFO Database Record (c) 2010 APA, all rights reserved
Authors: William J Kowalczyk; Karran A Phillips; Michelle L Jobes; Ashley P Kennedy; Udi E Ghitza; Daniel A Agage; John P Schmittner; David H Epstein; Kenzie L Preston Journal: Am J Psychiatry Date: 2015-03-17 Impact factor: 18.112
Authors: Wei-Yin Loh; Megan E Piper; Tanya R Schlam; Michael C Fiore; Stevens S Smith; Douglas E Jorenby; Jessica W Cook; Daniel M Bolt; Timothy B Baker Journal: Nicotine Tob Res Date: 2011-12-16 Impact factor: 4.244