Nicotine patch and lozenge 'best' for giving up smoking

In collaboration with the Press Association

Smokers who are determined to quit may want to consider using both nicotine patches and lozenges, after a new study found this to be the most effective combination of treatments for stopping smoking.

Nicotine patches and lozenges are examples of nicotine replacement therapies, which have been shown to double the chances of successfully quitting by reducing cravings.

Researchers at the University of Wisconsin Centre for Tobacco Research and Intervention set out to compare five different smoking cessation medications - nicotine lozenges; nicotine patches; the drug bupropion; patches and lozenges together; and bupropion with lozenges.

More than 1,500 people took part in the trial, all of whom smoked at least ten cigarettes per day and were keen to stop.

Participants who took bupropion were given the drug for one week before their quit date, and eight weeks afterwards, while the other therapies were used for eight to 12 weeks after the quit date. All the participants also had six individual counselling sessions.

After six months had passed, only those participants who were using both nicotine patches and lozenges were more successful at quitting than those taking a dummy treatment.

They were also more likely to stay off cigarettes for the first seven days and tended to avoid cigarettes for longer before relapsing.

Writing in the journal Archives of General Psychiatry, the researchers noted that few studies have compared how effective different types of stop-smoking treatments are.

And they suggested that the key to success seems to be pairing nicotine patches with something that can be taken when the person needs it - simply using a higher strength patch did not seem to make such a big difference.

In their conclusion, the study authors claimed that a combination of the nicotine patch and a form of nicotine replacement therapy that can be taken as needed - such as the lozenge - "should be routinely considered for use as a smoking cessation treatment".

Professor Robert West, Cancer Research UK's quit smoking expert, said: "Quitting smoking can be hard, but help is available. Counselling, patches, gums or lozenges have been shown to improve the chances of quitting successfully. Smokers are four times more likely to quit successfully if they get professional support than if they try to go cold-turkey.

"Several studies have shown that adding a faster-acting nicotine product such as gum to the patch boosts success rates. This should now be considered standard practice rather than using the products in isolation."

References

Piper, M et al. A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies Arch Gen Psychiatry 2009;66(11):1253-1262.