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Nicotine Gum OK for Gradual Quitters

Study Shows Nicotine-Replacement Gum Works Even If You Don't Quit Smoking Cold Turkey
By
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 8, 2009 -- Cigarette smokers who try to quit gradually rather than giving up smoking all at once can safely use nicotine-replacement gum, a new study shows.

Heavy smokers in the study who chewed the highest doses of nicotine-replacement gum as they tried to cut down on their smoking reported no more side effects than lighter smokers who chewed less nicotine gum.

The research was funded by GlaxoSmithKline, which markets Nicorette -- the nicotine- replacement gum used in the study. The study appears in the February issue of the American Journal of Preventive Medicine.

For the first two months of the study, the smokers were told to gradually reduce their smoking while increasing their nicotine gum use, with the goal of giving up cigarettes altogether.

Compared to smokers randomly assigned to a group using a placebo instead of nicotine gum, use of nicotine gum appeared to triple the odds of being a nonsmoker at six months.

Just 2% of placebo-gum users achieving this goal, compared to 6% of nicotine-gum users.

"Nicotine-replacement therapies like gums and patches are approved for abrupt quitting, but many people prefer to try and quit gradually by cutting down cigarettes rather than giving them up all at once," study researcher Saul Shiffman, PhD, tells WebMD. "Our finding is very reassuring because it shows this to be a safe way to use these products."

Smokers Who Quit Gradually

Studies suggest that only about 3% of attempts to stop smoking without the aid of nicotine replacement, other medications, behavioral therapy, or some other type of treatment are successful.

Shiffman, who is a long-time smoking-cessation researcher as well as a consultant for GlaxoSmithKline, says many smokers who want to quit express a preference for quitting gradually.

But it has not been known if they could safely do so using nicotine-replacement products at the same time.

In an effort to study this, the University of Pittsburgh professor of psychology and colleagues recruited almost 3,300 smokers from across the country. All had expressed an interest in quitting smoking gradually instead of stopping "cold turkey."

The smokers were allowed to choose either 2-milligram or 4-milligram doses of nicotine gum, but some of the participants in both groups unknowingly got a placebo rather than active-nicotine gum.

The 4-milligram dosage is generally recommended for heavy smokers -- those who typically smoke 25 or more cigarettes a day.

Participants were instructed to cut down on cigarettes while increasing their use of the gum over a two-month period, but they were not given explicit instructions on how to do this, Shiffman says. Participants reviewed FDA-approved labeling for the gum products.

Those who reported giving up cigarettes at the end of two months were followed for an additional four months, during which time they were allowed, but not required, to continue using the nicotine-replacement gum or a placebo.

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