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Nicotine patch plus lozenge best for quitting smoking

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CTV.ca News Staff

Date: Tuesday Nov. 3, 2009 9:31 PM ET

The first head-to-head comparison of a number of stop-smoking aids available on the market has found that nicotine patches combined with the occasional nicotine lozenge works best of all.

The study, published in the Archives of Psychiatry, was the first large, randomized controlled trial to compare the success rates of the stop-smoking aids. Until now, most studies on "smoking cessation" tools simply compared them to a placebo, not against one another.

Researchers from the University of Wisconsin Center for Tobacco Research and Intervention wanted to know which worked better: the antidepressant medication often prescribed for smokers wanting to quit, called bupropion (sold as Zyban or Wellbutrin), or less expensive nicotine patches, lozenges, or a combination.

They had more than 1,500 smokers, who were ready to quit, compare five real treatments and one fake one:

  • nicotine lozenge alone,
  • nicotine patch alone,
  • bupropion alone,
  • patch plus nicotine lozenge,
  • bupropion plus nicotine lozenge
  • placebo

Because bupropion takes a while to become effective, that treatment began one week before a designated quit date and continued for eight weeks. All the other treatments were taken for eight to 12 weeks after the quit date.

There were no serious side effects reported from any of the treatment options. The participants were also offered six individual counselling sessions.

Six months after the treatments were begun, only those smokers who combined the nicotine patch and lozenges were more successful in quitting than those taking placebo. Of them, 40 per cent reported they were no longer smoking six months out.

Smokers using the patch-lozenge combo were also more likely to have quit at seven days and tended to have other more positive outcomes, such as a longer period of time before relapsing.

In addition, the combination, along with the patch alone, were most effective at helping people achieve at least one day of abstinence from smoking, an important stepping stone to successful quitting.

It's thought that the patch-lozenge combo worked because it supplied a steady supply of nicotine while the lozenges gave users a "boost" of nicotine when they had an extra craving.

While nicotine lozenges were chosen for the study, the researchers say similar results would likely be found with other "adjuvant" nicotine replacements such as nicotine gum, nasal spray or an inhaler.

"The key seems to be that an ad libitum, or as needed, agent must be paired with the patch; simply using higher patch doses does not seem to augment outcomes to the same degree," the authors write.

This research was funded by the U.S. National Institutes of Health. Medication was provided free by drug maker GlaxoSmithKline. Several of the study authors reported financial ties to different pharmaceutical companies.

Comments are now closed for this story

Just don't take away my coffee!
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Sounds interesting, I may have to give this a shot.

Robert, Winnipeg
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I was a 25 year smoker. I used Zyban 6 months ago, and it worked. No side effects. See your doctor about it. And Zyban is less expensive than the patch.

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I've used the patch/lozenge combination a couple times with little success. Th only thing that's been working for me is smoking whitecloudecigoutlet. I haven't smoked a tobacco cigarette in a LONG time since I've switched to e-cigarettes. And I'm now weening myself off of e-cigarettes, too.I just think smokers need to be more realistic. It's been known for a long time that patches and lozenges are not very successful for many, many smokers. They may work for some, but not for most.

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I have read a book written by Allen Carr called "The Only Way to Stop Smoking Permanently ". The book is hard to find. Check on the internet, I am sure you can find a copy somewhere. Don't use the abbreviated version; I have heard it does not work as well as the complete version. Me and my wife have quit smoking 5 years ago and we have not had one craven since. Thanks to Allen Carr.

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I quit 11 years ago using Zyban AND a nicotine patch after smoking for 30 years. I had bizarre dreams and difficulty sleeping while on the Zyban (it is a stimulant) but it was worth the temporary side effects.I am so thankful that I was finally able to quit...and have been feeling great since. You really do need to be motivated to quit though, or nothing will work.

Non Smoker
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The best way to stop smoking is with the LASER.. I smoked for over 30 years tried every drug, patch, gum you name it and the only thing that got me to stop was laser. I sent all my friends as well and every single one is now smoke free. Non-smoker

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Newest thing out now is Champix, and there are less side effects than Ziban(other than the vivid dreams). Quitting smoking was a "piece of cake". I just don't get those gums and lozenges, fighting fire with fire? Eventually you have to ween yourself off that inevitable addiction.

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This is like replacing your crack pipe with a syringe full of meth and a cocaine lozenge and then claiming you've quit smoking crack. Nice try. Play again lol.

Rick in NB, Ste Marie
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It's a wonder Glaxo Smith Kline could provide the free Meds. According to our health minister their Quebec branch can't meet her demands for flu vaccines. If anyone is wondering why i take shots at our health minister. It's because i tried to get my flu shot and was turned away last week. Thanks to all the prep work done by the new conservative government i now am on my 3rd day with the flu. I hope you find out how incompitent some people have been the easy way. Not by infection, it sucks.

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I smoked for many years and only quit while using the patch and for ten years I went about life not smoking but had a constant desire for a cigarette. I picked up smoking again in 2006, after a ten year nicotine fit, and was a 2 pack a day smoker in no time. I didn't want to quit this time but on a dare I went to my family physician in January and asked him about trying a pill thay I heard about. It is called Champix , and you take the pills, keep on smoking and within a couple weeks you just stop smoking and a couple weeks later you forget about smoking at all. It has something to do with repairing the nicotine receptors in the brain. HONEST, if you are have real trouble quitting and have absolutely no will power, go to your family physician and ask about this medicine. It has worked for me.

Ken in Ottawa
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My partner tried Champix and started having severe nausea in the mornings. When he checked with our family doctor he was told that several other patients had been experiencing the same side effects so our doctor has discontinued prescribing it to her patients.

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I finally quit smoking by looking at my 5 year old and asking him if he wanted me to quit. I also told him that I would ask him if I could have one when I was craving. Been smoke free for 2 months and have no urge whatsoever to start again. 22 years since i started and this is the longest I have been without. I barely even think about it now.

Robert Orr
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Another vote for Allen Carr, quit after 25 years and it was painless.

Joe in NB
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Get a prescrition for Champix! I smoked for 25 years but have now been smoke free for almost a year thanks to it.Now working out five times a week. At 41 I'm in the best shape of my life and have never felt better!

david sawkiw[saskatchewan farmer]
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If the government supplies free needles and 'safe' houses and other free drugs for heroine addicts,,, why not free help for nicotine addicts???But oh wait a minute,, the hard drugs lead to escalating health care costs, from hiv or hep 123.I guess the health care costs for nicotine addictions are unknown or at least un -proven.......

darren ex smoker
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The actual best way to smoke, is for you to

#1 believe you can do it.

#2 have a support that believes you can do it (spouse, family, co-workers)

#3 Alienate yourself from people who smoke

#4 believe in the product you are going to try, be it zyban, or patch or losenge

#5 understand that you may fall off the wagon, and if you do, you need to get back on the zyban or patch or losenge or champex imediately and go through the process again.

#6 remember "just one or just a puff" can never ever lead to a good thing, just say no.

#7 when you do start on the zyban or others, even though you are allowed to smoke a little, always always always try to hang on 5 more minutes or 10 more minutes make a game out of it. Say ok i will start with 5 minutes, then after a day try waiting an extra 10 minutes before lighting up. keep making yourself personal bests.

#8 know that there are certain landmarks that you have to get over that can be tought. 1 day, 2 days, 1 week 2 weeks, 1 month 2 months, after this the landmarks get easy to get over.

#9 never ever ever use stress as a reason to light up. use the 5 or 10 minute rule so you are not lighting up because of stress

#10 you are going to gain weight. get over it, after you have aced the no smoking, then get on the treadmill and loose the weight.

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All you need is willpower. I didn't use any aids and have been smoke free for more than 3 years now.

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This is a good article. With the slowness of getting the vaccine to "us regular people" there is bound to be a lot of people self medicating. And there is always someone out there who will try to make a buck on people's concerns or fears. I hope this article gets read by all.

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