Literature DB >> 8518572

Targeting heavy smokers in general practice: randomised controlled trial of transdermal nicotine patches.

M A Russell1, J A Stapleton, C Feyerabend, S M Wiseman, G Gustavsson, U Sawe, P Connor.   

Abstract

OBJECTIVES: (a) To evaluate the efficacy of transdermal nicotine patches as an aid to stopping smoking when used as an adjunct to brief advice and support in a general practice setting; (b) to see whether an increase in nicotine patch dosage enhances the rate of initial cessation.
DESIGN: Randomised double blind placebo controlled parallel group study with one year of follow up.
SETTING: 30 general practices in 15 English counties.
SUBJECTS: 600 dependent heavy smokers (> or = 15 cigarettes daily) who were well motivated to give up.
INTERVENTIONS: Brief general practitioner advice, booklet, and 16 hours per day patch treatment for 18 weeks with brief support and follow up at one, three, six, 12, 26, and 52 weeks. MAIN OUTCOME MEASURES: Self reported complete abstinence for up to one year with biochemical validation at all follow up points.
RESULTS: Nicotine patches reduced the severity of craving and adverse mood changes in the first weeks of withdrawal and doubled the rate of initial cessation at week 3 (nicotine group 36% of patients (144/400), placebo group 16.5% of patients (33/200)) and of continuous abstinence throughout one year (nicotine group 9.3% (37), placebo group 5.0% (10)). A dose increase at week 1 among patients experiencing difficulty in quitting increased the proportion who achieved abstinence at week 3. There were no adverse systemic effects attributable to nicotine, but the incidence of moderate or severe local irritation or itching at the patch site was 16.4% (63 patients), compared with 3.8% (seven) with placebo.
CONCLUSION: Transdermal nicotine patches used as an adjunct to brief advice and support in a general practice setting are an effective aid to long term cessation of smoking in highly dependent smokers.

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Year:  1993        PMID: 8518572      PMCID: PMC1677738          DOI: 10.1136/bmj.306.6888.1308

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  14 in total

1.  Randomised controlled trial of nasal nicotine spray in smoking cessation.

Authors:  G Sutherland; J A Stapleton; M A Russell; M J Jarvis; P Hajek; M Belcher; C Feyerabend
Journal:  Lancet       Date:  1992-08-08       Impact factor: 79.321

2.  Transdermal nicotine facilitates smoking cessation.

Authors:  J E Rose; E D Levin; F M Behm; C Adivi; C Schur
Journal:  Clin Pharmacol Ther       Date:  1990-03       Impact factor: 6.875

3.  Controlled trial of transdermal nicotine patch in tobacco withdrawal.

Authors:  T Abelin; A Buehler; P Müller; K Vesanen; P R Imhof
Journal:  Lancet       Date:  1989-01-07       Impact factor: 79.321

4.  Clinical and pharmacokinetic properties of a transdermal nicotine patch.

Authors:  S C Mulligan; J G Masterson; J G Devane; J G Kelly
Journal:  Clin Pharmacol Ther       Date:  1990-03       Impact factor: 6.875

5.  Meta-analysis of randomised controlled trials of nicotine chewing-gum.

Authors:  W Lam; P C Sze; H S Sacks; T C Chalmers
Journal:  Lancet       Date:  1987-07-04       Impact factor: 79.321

6.  Nicotine-replacement therapy with use of a transdermal nicotine patch--a randomized double-blind placebo-controlled trial.

Authors:  R D Hurt; G G Lauger; K P Offord; T E Kottke; L C Dale
Journal:  Mayo Clin Proc       Date:  1990-12       Impact factor: 7.616

Review 7.  Transdermal Nicotine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy as an aid to smoking cessation.

Authors:  K J Palmer; M M Buckley; D Faulds
Journal:  Drugs       Date:  1992-09       Impact factor: 9.546

8.  Predictors of outcome in a general practitioner intervention against smoking.

Authors:  P H Jackson; J A Stapleton; M A Russell; R J Merriman
Journal:  Prev Med       Date:  1986-05       Impact factor: 4.018

9.  Effect of general practitioners' advice against smoking.

Authors:  M A Russell; C Wilson; C Taylor; C D Baker
Journal:  Br Med J       Date:  1979-07-28

10.  Pre-abstinence smoke intake and smoking motivation as predictors of severity of cigarette withdrawal symptoms.

Authors:  R J West; M A Russell
Journal:  Psychopharmacology (Berl)       Date:  1985       Impact factor: 4.530

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  48 in total

1.  Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit.

Authors:  T Danielsson; S Rössner; A Westin
Journal:  BMJ       Date:  1999-08-21

Review 2.  Smoking cessation.

Authors:  I A Campbell
Journal:  Thorax       Date:  2000-08       Impact factor: 9.139

3.  Over-the-counter nicotine patch therapy for smoking cessation: results from randomized, double-blind, placebo-controlled, and open label trials.

Authors:  J T Hays; I T Croghan; D R Schroeder; K P Offord; R D Hurt; T D Wolter; M A Nides; M Davidson
Journal:  Am J Public Health       Date:  1999-11       Impact factor: 9.308

Review 4.  Teaching medical students about tobacco.

Authors:  R Richmond
Journal:  Thorax       Date:  1999-01       Impact factor: 9.139

5.  One year effectiveness of an individualised smoking cessation intervention at the workplace: a randomised controlled trial.

Authors:  F Rodríguez-Artalejo; P Lafuente Urdinguio; P Guallar-Castillón; P Garteizaurrekoa Dublang; O Sáinz Martínez; J I Díez Azcárate; M Foj Alemán; J R Banegas
Journal:  Occup Environ Med       Date:  2003-05       Impact factor: 4.402

Review 6.  A meta-analysis of the efficacy of over-the-counter nicotine replacement.

Authors:  J R Hughes; S Shiffman; P Callas; J Zhang
Journal:  Tob Control       Date:  2003-03       Impact factor: 7.552

7.  Effects of continuous nicotine infusion on nicotine self-administration in rats: relationship between continuously infused and self-administered nicotine doses and serum concentrations.

Authors:  Mark G LeSage; Daniel E Keyler; Greg Collins; Paul R Pentel
Journal:  Psychopharmacology (Berl)       Date:  2003-07-25       Impact factor: 4.530

8.  Adherence to nicotine replacement therapy versus quitting smoking among Chinese smokers: a preliminary investigation.

Authors:  Tai-Hing Lam; Abu Saleh M Abdullah; Sophia S C Chan; Anthony J Hedley
Journal:  Psychopharmacology (Berl)       Date:  2004-07-29       Impact factor: 4.530

9.  [Smoking cessation in primary and specialized care: a real opportunity and a public health necessity].

Authors:  M Torrecilla García; M Barrueco; J A Maderuelo; C Jiménez Ruiz; M D Plaza Martín; M A Hernández Mezquita
Journal:  Aten Primaria       Date:  2002-09-15       Impact factor: 1.137

Review 10.  The benefits of stopping smoking and the role of nicotine replacement therapy in older patients.

Authors:  S G Gourlay; N L Benowitz
Journal:  Drugs Aging       Date:  1996-07       Impact factor: 3.923

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