Combo drug therapies best for helping smokers quit

NEW YORK Tue Dec 15, 2009 4:32pm EST

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NEW YORK (Reuters Health) - Nearly one in five smokers offered help in kicking the habit while visiting their doctor's office for a check-up will make a serious attempt to quit, a new study shows.

And in this "real world" setting, the most effective smoking cessation drug therapy was a combination of bupropion SR (a sustained-release form of Zyban) and nicotine lozenges, Dr. Stevens S. Smith of the University of Wisconsin School of Medicine and Public Health in Madison and colleagues found.

The researchers asked 7,128 people who smoked at least 10 cigarettes a day and were attending a routine primary care appointment if they would be interested in trying to quit. The 1,346 (18.9 percent) who agreed were randomly assigned to five different drug therapies: nicotine patch only, nicotine lozenge only, bupropion SR only, nicotine patch plus lozenge, and bupropion SR plus lozenge. The drugs were given free to the study participants, all of whom got a referral to a telephone quit line for counseling help.

Six months after starting their quit attempt, 30 percent of the study participants taking bupropion SR plus lozenges were still smoke-free, compared to 17 percent of those on bupropion SR only, 20 percent using the lozenge alone, 18 percent of those using the patch alone, and 27 percent of people using the patch and lozenges.

The bupropion SR-lozenge combination was better than all the single drug therapies, while the patch-lozenge combination was more effective than patch only or bupropion SR only.

The researchers also found that 36 percent of the people who'd used more than 90 minutes of counseling were abstinent at six months, while those who used less or didn't get counseling at all had the same abstinence rate -- around 20 percent.

"These findings provide strong support for the wide-scale implementation of this efficient primary-care based intervention model that significantly reduces barriers to patient access to evidence-based cessation treatments," the researchers conclude.

SOURCE: Archives of Internal Medicine, December 14/28, 2009.

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Comments (2)
alphaleonis wrote:
I have smoked for twenty years and have had no luck or gain in willpower. Cigarettes are more addictive now than ever, and the chemicals that they put in them are not regulated by the government, they should be illegal. If marijuanna, which is definitely less of a health risk, a great cash crop, and is not addictive in any way is illegal, so should cigarettes be. But because the politicians draw so much in campaign contributions from the lobbyists from the companies, they will not be. When will people stop blaming smokers for being addicted to a product that has chemicals in them to make you addicted, and start cracking down on the companies for what they put into them… Benzine, which is a known carcinogen. I’d also like to speculate that they put white phosphorus in them as well, but it’s just a speculation.

Dec 16, 2009 11:47am EST  --  Report as abuse
loriarnp wrote:
I would have like to see Chantix used as part of this study. My patients have had great success with Chantix.

In reply to alphaleonis:
Marijuana is very addictive and just as dangerous to one’s health. What is differnt with marijuana is, no one smokes a pack-worth of joints a day. Thus, the health effects are greatly lessened. I agree with you that there needs to be more government regulation of tobacco companies.

Dec 17, 2009 10:05am EST  --  Report as abuse
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