A randomized clinical trial of nicotine lozenge for smokeless tobacco use

Jon Owen Ebbert, Herbert H. Severson, Ivana T Croghan, Brian G. Danaher, Darrell R. Schroeder

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Introduction: Smokeless tobacco (ST) use is associated with adverse health consequences, and effective treatments are needed. Pilot data suggest that 4-mg nicotine lozenge decreases tobacco craving and nicotine withdrawal symptoms among ST users. Methods: We conducted a randomized, placebo-controlled multicenter clinical trial to evaluate the efficacy of 12 weeks of 4-mg nicotine lozenge for ST use. Results: We randomized 270 participants (136 active lozenge, 134 placebo). No significant differences were observed between the groups in biochemically confirmed all tobacco abstinence rates at Week 12 (36% lozenge vs. 27.6% placebo; odds ratio [OR] 1.5, 95% CI 0.7-2.1; p = .138). However, the 4-mg nicotine lozenge increased self-reported all tobacco abstinence (44.1% vs. 29.1%; OR 1.9, 95% CI 1.2-3.2; p = .011) and self-reported ST abstinence (50.7% vs. 34.3%; OR 2.0, 95% CI 1.2-3.2; p = .013) compared with placebo at the end of treatment (Week 12). Following target quit date (TQD), nicotine withdrawal symptoms decreased significantly with time (time effect = -.022 per day, SE = .003; p < .001) and was significantly lower for the active lozenge (treatment effect = .213, SE = .071; p = .003). Tobacco craving also decreased significantly following TQD (time effect = -.071, SE = .006; p < .001) and was lower for the active nicotine lozenge (treatment effect = -.452, SE = .164; p = .006). Discussion: The 4-mg nicotine lozenge increased self-reported but not biochemically confirmed tobacco abstinence rates at 3 months. The use of the 4-mg nicotine lozenge is associated with decreased nicotine withdrawal symptoms and tobacco craving.

Original languageEnglish (US)
Pages (from-to)1415-1423
Number of pages9
JournalNicotine and Tobacco Research
Volume11
Issue number12
DOIs
StatePublished - 2009

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Tobacco Use Cessation Products
Smokeless Tobacco
Tobacco Use
Tobacco
Randomized Controlled Trials
Substance Withdrawal Syndrome
Nicotine
Placebos
Odds Ratio
Controlled Clinical Trials
Therapeutics
Multicenter Studies
Health
Craving

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

A randomized clinical trial of nicotine lozenge for smokeless tobacco use. / Ebbert, Jon Owen; Severson, Herbert H.; Croghan, Ivana T; Danaher, Brian G.; Schroeder, Darrell R.

In: Nicotine and Tobacco Research, Vol. 11, No. 12, 2009, p. 1415-1423.

Research output: Contribution to journalArticle

Ebbert, Jon Owen ; Severson, Herbert H. ; Croghan, Ivana T ; Danaher, Brian G. ; Schroeder, Darrell R. / A randomized clinical trial of nicotine lozenge for smokeless tobacco use. In: Nicotine and Tobacco Research. 2009 ; Vol. 11, No. 12. pp. 1415-1423.
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abstract = "Introduction: Smokeless tobacco (ST) use is associated with adverse health consequences, and effective treatments are needed. Pilot data suggest that 4-mg nicotine lozenge decreases tobacco craving and nicotine withdrawal symptoms among ST users. Methods: We conducted a randomized, placebo-controlled multicenter clinical trial to evaluate the efficacy of 12 weeks of 4-mg nicotine lozenge for ST use. Results: We randomized 270 participants (136 active lozenge, 134 placebo). No significant differences were observed between the groups in biochemically confirmed all tobacco abstinence rates at Week 12 (36{\%} lozenge vs. 27.6{\%} placebo; odds ratio [OR] 1.5, 95{\%} CI 0.7-2.1; p = .138). However, the 4-mg nicotine lozenge increased self-reported all tobacco abstinence (44.1{\%} vs. 29.1{\%}; OR 1.9, 95{\%} CI 1.2-3.2; p = .011) and self-reported ST abstinence (50.7{\%} vs. 34.3{\%}; OR 2.0, 95{\%} CI 1.2-3.2; p = .013) compared with placebo at the end of treatment (Week 12). Following target quit date (TQD), nicotine withdrawal symptoms decreased significantly with time (time effect = -.022 per day, SE = .003; p < .001) and was significantly lower for the active lozenge (treatment effect = .213, SE = .071; p = .003). Tobacco craving also decreased significantly following TQD (time effect = -.071, SE = .006; p < .001) and was lower for the active nicotine lozenge (treatment effect = -.452, SE = .164; p = .006). Discussion: The 4-mg nicotine lozenge increased self-reported but not biochemically confirmed tobacco abstinence rates at 3 months. The use of the 4-mg nicotine lozenge is associated with decreased nicotine withdrawal symptoms and tobacco craving.",
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