Patch plus lozenge equals more quitting success

By Anne Harding

NEW YORK (Reuters Health) - Smokers who are ready to quit will have the most luck if they combine the nicotine patch with nicotine lozenges and some counseling or coaching, a new study shows.

Among study participants who used this combination, 40 percent were still smoke-free at six months. The success rate for people who try to quit on their own is around 5 percent, Dr. Megan E. Piper of the University of Wisconsin School of Medicine and Public Health in Madison, the study's lead author, told Reuters Health.

To date there have been no studies comparing different smoking cessation aids head-to-head, she and her colleagues note in the Archives of General Psychiatry. To find out what approach worked best, they randomly assigned 1,504 smokers who were motivated to quit to one of six groups: nicotine lozenges, nicotine patch, sustained release bupropion (Wellbutrin), patch plus lozenge, bupropion plus lozenge, or placebo.

Treatment lasted for eight weeks, during which time the study participants each received six individual counseling sessions.

All of the treatments were better than placebo, Piper and her team found. But the patch combined with the lozenge was the most effective, and the only treatment that was significantly better than placebo for helping people to remain abstinent for six months.

While it's not clear why the patch plus lozenge might work best, Piper noted, the patch lets smokers maintain a steady level of nicotine in their blood, which helps fight withdrawal symptoms. When a person has a craving for a cigarette, she added, they can pop a lozenge instead.

It's important to understand that the medications were not given in isolation, but accompanied by counseling, Piper said. To get help, people can look for smoking cessation programs in their area. Another option is to call 1-800-QUIT NOW. The hotline, available in every state, offers free coaching to anyone who calls.

Given that cigarette prices are skyrocketing, the researcher added, now is a great time for people to try to quit. "If you combine the coaching and counseling with the patch and lozenge you have a really, really good chance of succeeding," she said.

SOURCE: Archives of General Psychiatry, November 2009.