eCite Digital Repository

Effectiveness of nicotine gum in preventing lapses in the face of temptation to smoke among non-daily smokers: a secondary analysis


Shiffman, S and Ferguson, SG and Mao, J and Scholl, SM and Hedeker, D and Tindle, HA, Effectiveness of nicotine gum in preventing lapses in the face of temptation to smoke among non-daily smokers: a secondary analysis, Addiction, 115, (11) pp. 2123-2129. ISSN 0965-2140 (2020) [Refereed Article]

Copyright Statement

2020 Society for the Study of Addiction

DOI: doi:10.1111/add.15083


Background and aims: Non-daily smokers (NDS) comprise a large fraction of US smokers. Despite little or no dependence, as typically assessed, intermittent smokers (ITS) have difficulty quitting smoking. A randomized clinical trial comparing the effect of nicotine gum with placebo on quitting smoking in non-daily smokers did not find an effect on overall abstinence. We undertook an analysis to assess whether using nicotine gum versus placebo when tempted to smoke could reduce incidence of lapses in those situations.

Design: Within a 6-week randomized, placebo-controlled clinical trial of nicotine gum, analyses contrasted the outcome of temptation episodes where gum was or was not used.

Setting: Smoking cessation research clinic in Pittsburgh, PA, USA.

Participants: A total of 255 adult ITS (131 nicotine gum, 124 placebo) seeking help for smoking cessation.

Intervention: Nicotine gum (2 mg) versus placebo for up to 8 weeks, with as-needed dosing instructions.

Measurements: Outcome was lapsing in temptation episodes, as reported by participants via ecological momentary assessment (EMA). Propensity scores predicting gum use from situational factors (e.g. mood, social setting, smoking cues) served as a control variable.

Findings: Participants reported 2713 temptation episodes, 46.0% (1248) of which resulted in smoking (lapsing). There was a significant gum use active treatment interaction (P = 0.0009). Using nicotine gum decreased the odds of lapsing by 55% compared with using placebo [odds ratio (OR) = 0.45; 0.22-0.94]; when gum was not used, the assigned gum condition made no significant difference (OR = 1.53; 0.78-3.01; Bayes factor = 0.14). The nicotine effect was not reliably different when participants were trying to achieve abstinence versus when trying to maintain abstinence (OR = 0.44; 0.10, 2.03; P = 0.294; Bayes factor = 0.11), for men and women (OR = 1.68; 0.58, 4.87; P = 0.343; Bayes factor = 0.10), or for participants with some or no dependence (OR = 0.88; 0.30, 2.59; P = 0.811; Bayes factor = 0.06).

Conclusions: When used in response to temptation to smoke, 2 mg nicotine gum can help to prevent lapses among non-daily smokers.

Item Details

Item Type:Refereed Article
Keywords:craving, nicotine gum, non-daily smokers, relapse, smoking, smoking cessation
Research Division:Health Sciences
Research Group:Public health
Research Field:Health promotion
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Preventive medicine
UTAS Author:Ferguson, SG (Professor Stuart Ferguson)
ID Code:139393
Year Published:2020
Deposited By:Medicine
Deposited On:2020-06-14
Last Modified:2021-09-28

Repository Staff Only: item control page