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Cited by 133Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

Aiding reduction of smoking with nicotine replacement medications: hope for the recalcitrant smoker?

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Fagerstrom, K. O., Tejding, R., Westin, A., Lunell, E.·1997·Tobacco Control
DOI 10.1136/tc.6.4.311PMC PMC1759592
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Abstract

OBJECTIVE: To assess the effect of the various nicotine replacement therapies (NRT) on smoking reduction. DESIGN: During an initial sampling week, the subjects familiarised themselves with nicotine gum, patch, nasal spray, vaporiser (vapour inhaler) and sublingual tablet. A crossover design was used during the next four study weeks; during two of these weeks the subjects could select one nicotine replacement product of their choice to use, whereas during the other two they were randomly assigned a product to use. SUBJECTS: 143 men and women smoking an average of 22.6 (SD 7.0) cigarettes per day and exhibiting a Fagerström Tolerance Questionnaire (FTQ) score of 7.0 (SD 1.9). INTERVENTIONS: Subjects were asked to use as much NRT as they wished, yet to smoke enough to feel comfortable. MAIN OUTCOME MEASURES: Self-reported cigarette consumption, exhaled carbon monoxide (CO), withdrawal symptom score, cotinine plasma levels and motivation to quit were monitored over a period of five weeks. RESULTS: Self-reported smoking declined steadily over the five weeks, from 22.6 (SD 7.0) to 10.4 (SD 1.0) (P<0.001) cigarettes daily (54% decrease), with the biggest drop (37%) during the first product-sampling week. Smoking reduction was greater on average during the weeks when the subjects could choose their nicotine product than when products were assigned. CO readings decreased from 22.7 (SD 8.5) to 14.8 (SD 8.4) ppm (P<0.001) confirming a reduction in smoking (35% decrease), although cotinine levels remained steady, suggesting that subjects were titrating nicotine to their original levels. Withdrawal scores decreased over time (32% decrease, P<0.001), showing that there was no discomfort associated with the smoking reduction, and motivation to quit was enhanced by the treatment in most subjects (93%). CONCLUSIONS: NRT for aiding smoking reduction appeared to be safe, was associated with a clinically significant reduction in smoke exposure over a five-week follow up, and increased motivation to stop smoking. A smoking reduction procedure may help the very recalcitrant smoker gain confidence and increase the control over his/her smoking behaviour. More controlled research is needed to follow up these promising results.

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  1. 1 Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMf 1994;309:911–18.
  2. 2 Higgins MW. Risk factors associated with chronic obstructive lung disease. Ann NY Acad Sci 1991;624:7–17.
  3. 7 Glasgow RE, Klesges RC, Klesges LM, Vasey MW, Gunnarsson DF. Long term effects of a controlled smoking program: a 21½2 year follow-up. Behav Ther 1985; 16:303-7.
  4. 6 Kuller LH, Ockene JK, Townsend M, Browner W, Meilahn E, Wentworth DN. The epidemiology of pulmonary function and COPD mortality in the Multiple Risk Factor Intervention Trial. Am Rev Respir Dis 1989;140:S78–81.
  5. 8 US Centers for Disease Control and Prevention. Indicators of nicotine addiction among women-United States, 1991-1992. MMWR 1995;44:102–5.
  6. 10 Henningfield JE, Keenan RM. The anatomy of nicotine addiction. Health Values 1993;17:12–19.
  7. 13 Tang JL, Law M, Wald N. How effective is nicotine replacement to stop smoking? BMf 1994;308:21–6.
  8. 12 Rennard SI, Daughton DM, Thompson AB, Fioreani AA, Romberger DJ, Millatmal T. The effects of nicotine replacement therapy on cigarette smoking reduction (abstract). American Lung Association/American Thoracic Society international conference. Boston, Massachusetts: ALA/ATS, 1994.
  9. 14 Heatherton TF, Kozlowski LT, Frecker RC, Fagerström K-O. The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br F Addict 1991;86:1119–27.
  10. 16 Schmitz JM, Rhoades H, Grabowski J. Contingent reinforcement for reduced carbon monoxide levels in methadone maintenance patients. Addict Behav 1995;20:171–9.
  11. 17 Hatsukami DK, Dalgren L, Hughes JR. Symptoms of tobacco withdrawal from abrupt cigarette cessation versus partial cigarette reduction. Psychopharmacology 1988; 94:242-7.
  12. 19 Working group for the study of transdermal nicotine in patients with coronary artery disease. Nicotine replacement therapy for patients with coronary artery disease. Arch Intern Med 1994;154:989–95.

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Authors
Fagerstrom, K. O., Tejding, R., Westin, A., & Lunell, E.
Venue
Tobacco Control
Publisher
BMJ
Published
1997-12-01
Volume
6
Issue
4
Pages
311-316
ISSN
0964-4563 (ISSN-L)
DOI
10.1136/tc.6.4.311
PMC
PMC1759592
OpenAlex
W2092725435
Cited by
133
References
12
Citations by year
2023: 6 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 7 · 2012: 4
FWCI
3.06
Type
journal article
Language
en
Open access
Locations
  • Tobacco Control (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
nicotine replacement therapy, smoking reduction, nicotine gum, nicotine patch, nasal spray, sublingual tablets, nicotine withdrawal symptoms, motivation to quit, exhaled carbon monoxide, cotinine, Fagerström Tolerance Questionnaire
MeSH terms
Adult, Carbon Monoxide, Cotinine, Female, Humans, Infant, Male, Middle Aged, Nicotine, Plants, Toxic, Surveys and Questionnaires, Saliva, Smoking, Substance Withdrawal Syndrome, Nicotiana, Tobacco Use Disorder, Smoking Cessation, Cross-Over Studies

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