Shiffman, S and Scholl, SM and Mao, J and Ferguson, SG and Hedeker, D and Primak, B and Tindle, HA, Using nicotine gum to assist nondaily smokers in quitting: a randomized clinical trial, Nicotine and Tobacco Research pp. 1-8. ISSN 1462-2203 (2019) [Refereed Article]
© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.
Introduction: Non-daily intermittent smokers (ITS) comprise 30% of US adult smokers. ITS smoke for nicotine and have trouble quitting, but tend to smoke in particular situations. This study tested the effect of nicotine gum, used to prevent or react to situational temptations, for helping ITS quit.
Methods: ITS (smoking 4–27 days/month) seeking help quitting were randomized to 2 mg nicotine gum (n = 181) or placebo (n = 188), to be used to anticipate or react to temptations to smoke, for 8 weeks. Participants received up to six sessions of behavioral counseling. The primary outcome was 6-month biochemically verified continuous abstinence; analyses also examined 14-day pointprevalence abstinence at multiple time points, and used event-history analyses to assess progression to abstinence, lapsing, and relapsing. Analyses adjusted for group differences in age and baseline smoking, and considered several potential moderators of treatment effects.
Results: Nicotine gum did not significantly improve outcomes on any measure. Biochemically verified 6-month continuous abstinence rates were 7.2% for active gum and 5.3% for placebo (AOR = 1.39, 0.58–3.29, p > .25). ITS with any degree of dependence (Fagerstrom Test of Nicotine Dependence scores >0) showed poorer outcomes on multiple endpoints, and did more poorly on active gum on some outcomes. Gum use was low, starting at 1 gum per day on average and declining over time.
Conclusions: Nicotine gum (2 mg), used intermittently, did not improve cessation rates among ITS, including those demonstrating some degree of dependence. Implications: Nicotine replacement has been extensively tested with daily smokers, especially those who smoke relatively heavily. Nondaily smoking is now common, creating a need for treatment for ITS. Despite evidence that ITS’ smoking is motivated by nicotine-seeking, a theoretically and empirically derived situational approach to using acute nicotine replacement was not successful at helping ITS quit. Gum use was low; whether higher or more frequent dosing is needed, or whether an entirely different approach is needed, is not clear. Effective treatment options are needed for ITS, especially those with some degree of dependence.
|Item Type:||Refereed Article|
|Keywords:||smoking cessation, non-daily smokers, intermittent smokers, nicotine gum|
|Research Division:||Psychology and Cognitive Sciences|
|Research Field:||Health, Clinical and Counselling Psychology|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Behaviour and Health|
|UTAS Author:||Ferguson, SG (Associate Professor Stuart Ferguson)|
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