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Does reducing withdrawal severity mediate nicotine patch efficacy? A randomized clinical trial.

journal contribution
posted on 2023-05-16, 23:48 authored by Stuart FergusonStuart Ferguson, Shiffman, S, Gwaltney, C
Nicotine replacement therapy (NRT) repeatedly has been shown to improve smoking treatment outcome. The major mechanism posited for this improvement in outcome is that NRT reduces nicotine craving and withdrawal. The authors tested this hypothesized mechanism of action using real-time data on craving and withdrawal, collected by ecological momentary assessments administered on a palm-top computer. Smokers (N = 324) were randomized to receive either active high-dose (35 mg) 24-hr patches or placebo. Increases in positive affect and decreases in craving, negative affect, and attention disturbance severity were related to lower risk of lapsing. Although NRT treatment did significantly decrease withdrawal and craving severity, these reductions only partially accounted for NRT's impact on time to first lapse: The results from a mediation analysis showed that the hazard ratio for NRT, when controlling for withdrawal and craving severity, was only a third to a half lower than the uncontrolled hazard ratio for NRT alone. This suggests that other mechanisms for the effectiveness of NRT need to be examined. © 2006 APA, all rights reserved.

History

Publication title

Journal of Consulting and Clinical Psychology

Volume

74

Issue

6

Pagination

1153-1161

ISSN

0022-006X

Department/School

School of Pharmacy and Pharmacology

Publisher

American Psychological Association

Place of publication

England

Rights statement

© Copyright 2006 American Psychological Association

Repository Status

  • Restricted

Socio-economic Objectives

Public health (excl. specific population health) not elsewhere classified

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