Chapter 22 Smoking and tobacco cessation

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Smoking and tobacco cessation: Nicotine replacement and

pharmacologic treatment

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Even with the aid of nicotine replacement therapy (patch or gum) which can triple the

rate of successful smoking cessation, only two to three percent of smokers

successfully quit each year.

only two to three percent of smokers successfully quit each year.

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Smoking abstinence rates were 27% for the active nicotine patch compared to 13%

for the placebo patch at the end of 4 to 8 weeks of treatment, and 22% compared to

9% at six months.

JAMA, June 7, 1995, p. 1657

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A meta-analysis of nicotine replacement therapy found the following one-year

effectiveness in achieving abstinence from smoking. For the nicotine patch, 16% (vs.

9% placebo controls); nicotine gum, 19% (11% placebo); and nasal spray, 24% (vs.

11% in the placebo or control population). All these results, while showing only modest

effectiveness, were highly clinically significant (p<0.001).

ACP (American College of Physicians) Journal Club, November/December 1996, p.

70

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In a study from 10 Veterans Affairs Medical Centers, use of transdermal nicotine

patches was shown not to cause a significant increase in cardiovascular events in

high risk patients with cardiac disease.

NEJM, December 12, 1996, p. 1792

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Nonprescription over the counter nicotine replacement products are estimated to yield

from 114,000 to 304,000 new former smokers annually in the United States. Their

use has increased by 152% compared to prior prescription use, and the cost for a

three month supply of nicotine patches is $300 to $350.

Tobacco Control, Winter 1997, pp. 306 and 563

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Thursday, July 06, 2000

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