Effect of high-dose nicotine patch therapy on tobacco withdrawal symptoms among smokeless tobacco users

Jon O. Ebbert, Lowell C. Dale, Christi A. Patten, Ivana T. Croghan, Darrell R. Schroeder, Thomas P. Moyer, Richard D. Hurt

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

No pharmacotherapies have been shown to increase long-term (≥6-month) abstinence rates among smokeless tobacco (ST) users. Available evidence suggests that underdosing may occur with standard-dose nicotine replacement therapy (NRT) in ST users. We investigated the effect of high-dose nicotine therapy on tobacco withdrawal symptoms among ST users in a randomized, controlled clinical pilot study. A total of 42 ST users using at least 3 cans or pouches per week were randomized to nicotine patch doses of 63, 42, or 21mg/day or placebo for 8 weeks. Multiple daily assessments of tobacco withdrawal and nicotine toxicity were obtained with an electronic diary. During the first week of nicotine patch therapy, we observed a dose-response relationship such that higher nicotine patch doses were associated with less decreased arousal (χ2 = 6.87, p = .009), less negative affect (χ2=3.85, p = .05), and less restlessness (χ2 = 3.90, p = .048). During the second week, higher nicotine patch doses were associated with less decreased arousal (χ2 = 6.77, p = .009). Overall, the frequency of nicotine toxicity symptoms did not differ by dose group. Of specific symptoms, nausea was observed to be more frequent in the 63 mg/day dose group compared with placebo (p = .035). In conclusion, high-dose nicotine patch therapy resulted in a greater reduction of tobacco withdrawal symptoms among ST users using at least 3 cans per week. High-dose nicotine patch therapy is safe and well tolerated in this population of tobacco users.

Original languageEnglish (US)
Pages (from-to)43-52
Number of pages10
JournalNicotine and Tobacco Research
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2007

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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