More Smokers Quit With Patches and Lozenges
Study Shows Combination Treatment Yields Best Smoking-Cessation Results
Nov. 2, 2009 -- Smokers who want to kick the habit are more likely to
succeed when they use a combination of long-acting and immediate-delivery
nicotine-replacement products, a study shows.
Study participants who used nicotine patches plus nicotine lozenges were
more successful than participants who used either product alone. They also had
better outcomes than those who used the smoking-cessation drug Zyban or a
combination of Zyban and nicotine lozenges.
Compared to smokers who received none of these treatments, smokers who
combined the patch with immediate-delivery nicotine lozenges were twice as
likely to be nonsmokers six months after entering the study.
The study is not the first to suggest that two types of nicotine replacement
are better than one. Government researchers came to a similar conclusion in a
research analysis published in 2008.
Investigator Megan E. Piper, PhD, of the University of Wisconsin Center for
Tobacco Research and Intervention, says all the medical interventions evaluated
in the latest study were effective.
"But the combination of the patch and lozenge along with individual
counseling gave people the best chance of quitting," she says.
The Role of Counseling
Piper tells WebMD that counseling was an important component of the
All 1,504 smokers in the study participated in six individual counseling
sessions even if they received no other medical intervention to help them
The study was designed to compare the effectiveness of five
smoking-cessation strategies compared to placebo: nicotine-replacement lozenges
alone, nicotine patches alone, Zyban alone, patches and lozenges, and Zyban
Smoking cessation success was assessed at one week, eight weeks, and six
months after the quit date. In addition to asking participants if they were
still smoking, the researchers measured carbon monoxide levels in their breath
as an independent measure of smoking cessation.
Six months after enrolling in the study:
- 22% of the participants who received counseling, but no other active
medical intervention, had stopped smoking.
- 40% of the participants who used nicotine patches and lozenges had stopped
- The success rate was similar (32% to 34%) among participants treated with
patches alone, lozenges alone, Zyban alone, or Zyban plus lozenges.
The study appears in the November issue of Archives of General
Zyban, an antidepressant also marketed by the drug company GlaxoSmithKline
under the brand name Wellbutrin -- is one of two prescription drugs approved
for smoking cessation in the U.S.
The other, marketed by Pfizer as Chantix, was not evaluated in the new
Piper says smokers have more options than ever to help them free themselves
of cigarettes, including a federally funded hotline that provides telephone
access to a specially trained counselor.
The hotline -- 1-800-QUIT NOW (784-8669) -- connects smokers who want to
quit to their own state's smoking-cessation program.
Melissa Blair, who is director of nutrition and wellness for the state of
Tennessee, tells WebMD the counselors, known as Quit Coaches, offer strategies
to help a smoker quit.
In many states, including Tennessee, smokers who cannot afford
nicotine-replacement products or drug treatments can get them free through
their local health departments.
Smokers who enroll in the state's smoking-cessation program are assigned a
specific counselor. They can call their Quit Coach whenever they need to and
the counselor also calls them periodically to see how they are doing.
"This is a free service and it provides the extra support many people need
to be successful," Blair says.
The North American Quitline Consortium provides information on
smoking-cessation services provided by individual states.