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Effectiveness of nicotine gum in preventing lapses in the face of temptation to smoke among non-daily smokers: a secondary analysis

Shiffman, S, Ferguson, SG ORCID: 0000-0001-7378-3497, Mao, J, Scholl, SM, Hedeker, D and Tindle, HA 2020 , 'Effectiveness of nicotine gum in preventing lapses in the face of temptation to smoke among non-daily smokers: a secondary analysis' , Addiction , pp. 1-7 , doi: 10.1111/add.15083.

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Background and aims: Non-daily smokers (NDS) comprise a large fraction of US smokers. Despite little or no dependence, as typically assessed, intermittent smokers (ITS) have difficulty quitting smoking. A randomized clinical trial comparing the effect of nicotine gum with placebo on quitting smoking in non-daily smokers did not find an effect on overall abstinence. We undertook an analysis to assess whether using nicotine gum versus placebo when tempted to smoke could reduce incidence of lapses in those situations.Design: Within a 6-week randomized, placebo-controlled clinical trial of nicotine gum, analyses contrasted the outcome of temptation episodes where gum was or was not used.Setting: Smoking cessation research clinic in Pittsburgh, PA, USA.Participants: A total of 255 adult ITS (131 nicotine gum, 124 placebo) seeking help for smoking cessation.Intervention: Nicotine gum (2 mg) versus placebo for up to 8 weeks, with as-needed dosing instructions.Measurements: Outcome was lapsing in temptation episodes, as reported by participants via ecological momentary assessment (EMA). Propensity scores predicting gum use from situational factors (e.g. mood, social setting, smoking cues) served as a control variable.Findings: Participants reported 2713 temptation episodes, 46.0% (1248) of which resulted in smoking (lapsing). There was a significant gum use × active treatment interaction (P = 0.0009). Using nicotine gum decreased the odds of lapsing by 55% compared with using placebo [odds ratio (OR) = 0.45; 0.22-0.94]; when gum was not used, the assigned gum condition made no significant difference (OR = 1.53; 0.78-3.01; Bayes factor = 0.14). The nicotine effect was not reliably different when participants were trying to achieve abstinence versus when trying to maintain abstinence (OR = 0.44; 0.10, 2.03; P = 0.294; Bayes factor = 0.11), for men and women (OR = 1.68; 0.58, 4.87; P = 0.343; Bayes factor = 0.10), or for participants with some or no dependence (OR = 0.88; 0.30, 2.59; P = 0.811; Bayes factor = 0.06).Conclusions: When used in response to temptation to smoke, 2 mg nicotine gum can help to prevent lapses among non-daily smokers.

Item Type: Article
Authors/Creators:Shiffman, S and Ferguson, SG and Mao, J and Scholl, SM and Hedeker, D and Tindle, HA
Keywords: craving, nicotine gum, non-daily smokers, relapse, smoking, smoking cessation
Journal or Publication Title: Addiction
Publisher: Blackwell Publishing Ltd
ISSN: 0965-2140
DOI / ID Number: 10.1111/add.15083
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© 2020 Society for the Study of Addiction

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