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Progressive nicotine patch dosing prior to quitting smoking: Feasibility, safety, and effects during the pre-quit and post-quit periods.
Addiction ; 2018 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-30370685
ABSTRACT

BACKGROUND AND AIMS:

Nicotine Replacement Therapy (NRT) may be more effective in aiding smoking cessation if higher doses of nicotine from it can be tolerated. We examined the responses to, and 4-week abstinence rates observed when, titrating the dose of transdermal nicotine patch up to 84mg/day over 4 weeks prior to a target quit date and titrating down again over 4 weeks afterwards.

DESIGN:

Clinical cohort study.SETTING: Tobacco dependence clinic, Mar del Plata, Argentina.PARTICIPANTS: 50 smokers seeking help with stopping.INTERVENTION: Participants started on one 21mg/24 hour patch 4 weeks prior to their target quit day (TQD). The dose was increased weekly by adding a 21mg patch unless participants reported adverse effects and did not wish to increase the dose. The dose was reduced by 21mg/day each week from 1 week post-TQD, until it reverted back to the standard dose (21mg/day) at 4 weeks post-TQD. Participants received weekly behavioural support and could also use oral NRT from the TQD. Participants were advised to smoke ad-libitum during the pre-quit period.MEASUREMENTS: Proportion of participants progressing through each stage of dosing, adherence, adverse effects, changes in cigarette consumption, smoke intake and enjoyment of smoking during the pre-quit period; withdrawal symptoms; carbon-monoxide validated abstinence during 4-weeks post-TQD.

FINDINGS:

Of the 50 participants, 72.0% (N=36) progressed to the 84mg nicotine dose and 94.0% (N=47) completed the trial. Adverse effects consisted primarily of nausea and were mild and well tolerated. Cigarette consumption, smoke intake and enjoyment of smoking declined significantly during the pre-quit period. Forty-one (82%) participants achieved 4 weeks validated abstinence. Abstainers experienced no detectable cigarette withdrawal symptoms.

CONCLUSIONS:

Many smokers seeking help with stopping appear to be able to tolerate doses of transdermal nicotine patch up to 84mg/day during a 4-week pre-quit up-titration period with minimal side effects.

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Aspecto clínico: Etiologia Idioma: Inglês Assunto da revista: Transtornos Relacionados com Substâncias Ano de publicação: 2018 Tipo de documento: Artigo