BALTIMORE – Using a nicotine patch or bupropion with a nicotine lozenge was the most effective of five therapies tested for promoting smoking abstinence and avoiding a lapse or relapse into smoking, according to a prospective study of 1,504 smokers.
The therapies were “significantly better than placebo in promoting initial abstinence” and were effective int preventing relapse, reported Sandra Japuntich, Ph.D., a postdoctoral fellow at Massachusetts General Hospital's Mongan Institute for Health Policy, Boston.
The study's importance lies in its examination of the effects of each therapy closer to the smokers' targeted quit dates, she said.
The placebo-controlled trial sought to identify the effects on smoking cessation milestones of five pharmacologic therapies: nicotine lozenge, nicotine patch, bupropion, bupropion with a nicotine lozenge, and nicotine patch with a nicotine lozenge.
The milestones were one period of 24-hour abstinence within 2 weeks of a target quit date, lapsing with at least one cigarette, and relapsing into regular smoking for at least 7 consecutive days.
A total of 70% of smokers on placebo initially abstained, compared with 92% of those using a nicotine patch with a lozenge, 86% on bupropion with a lozenge, 81% on bupropion, 81% on a lozenge, and 88% on a nicotine patch.
Of those who initially abstained, 83% on placebo lapsed, compared with 70% those using a patch with a lozenge, 71% on bupropion with a lozenge, 74% on bupropion, 73% on a lozenge, and 76% on a patch.
Of those who lapsed, 69% on placebo relapsed, compared with 61% using a nicotine patch, 64% on bupropion with a lozenge, 63% on bupropion, 62% on a lozenge, and 61% on a patch with a lozenge.
The strongest treatment effects happened in the first week or two, she said. Those patients who do not stay abstinent might need to try another therapy.
Dr. Japuntich reported no conflicts of interest. One coinvestigator has served on research projects sponsored by a number of pharmaceutical companies.