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-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."
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