Quitting by Gradual Smoking Reduction Using Nicotine Gum: A Randomized Controlled Trial
Background
Many smokers express a desire to quit smoking by gradually reducing the number of cigarettes they smoke until they stop completely. This study tested the efficacy of nicotine gum in facilitating cessation through gradual reduction.
Design
This was a multi-center, placebo-controlled, double-blind RCT of 2- and 4-mg nicotine gum versus placebo.
Setting/participants
3297 smokers who were interested in quitting gradually.
Intervention
Subjects were instructed to gradually reduce their smoking while increasing their gum use over the course of up to 8 weeks. Once they had achieved initial abstinence (no smoking for 24 hours), gum was to be used in accordance with the current FDA-approved directions for cessation. The study was conducted under over-the-counter conditions, with no counseling provided. Continuous abstinence was assessed after 28 days and 6 months. Secondary measures of smoking reduction were also assessed. Analyses were conducted in 1999–2000 and 2007–2008.
Main outcome measures
Smokers on active gum were significantly more likely to achieve initial cessation (2 mg: OR=1.42; 4 mg: OR=1.90); 28-day continuous abstinence (2 mg: OR=2.01; 4 mg: OR=4.66); and continuous abstinence at 6 months (2 mg: OR=1.80; 4 mg: OR=5.96). During the reduction phase, active gum aided smoking reduction, and participants who reduced their smoking were more likely to achieve abstinence.
Conclusions
These findings demonstrate that smokers who wish to quit smoking by gradual reduction can increase their success by using nicotine gum to facilitate reduction and cessation.
aPinney Associates, Inc., and the University of Pittsburgh, Pittsburgh, Pennsylvania
bGlaxoSmithKline Consumer Healthcare, Parsippany, New Jersey
Address correspondence and reprint requests to: Saul Shiffman, PhD, Pinney Associates, 201 North Craig Street, Suite 320, Pittsburgh PA 15213
ABSTRACT