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Efficacy of a nicotine nasal spray in smoking cessation: a placebo-controlled, double-blind trial
Authors:NINA G SCHNEIDER  RICHARD OLMSTEAD  FRENY VAGHAIWALLA MODY  KIM DOAN  MIKAEL FRANZON  MURRAY E JARVIK  CRAIG STEINBERG
Institution:West LA VA Medical Center, Los Angeles, California, USA;UCLA School of Medicine, Los Angeles, California, USA;UCLA Department of Psychology, Los Angeles, California, USA;Pharmacia Inc., Columbus, Ohio, USA;Vanderbilt University, Tennessee, USA
Abstract:Laboratory trials have demonstrated the efficacy of nicotine replacement in smoking cessation bur absolute success races are low. For many, nicotine gum is hard to use and transdermal nicotine is slow-acting and passive. A new, faster-acting nicotine nasal spray (NNS) can provide easily self-administered relief from cigarette withdrawal. The NNS was tested for safely and efficacy in smoking cessation. Two hundred and fifty-five smokers were randomized to NNS or a piperine placebo. Drug use was limited to 8–32 doses/day for 6 months. Subjects were tested while smoking and at post-cessation daily (week 1) with follow-up at weeks 2, 3, 6 and at 3 months, 6 months and 1 year. Continuous abstinence analyses (CO ≤8 ppm.; no slips) showed that NNS significantly enhanced success rates over placebo overall (p < 0.001) and at all test intervals. Differences at key intervals between active and placebo were: 63% vs. 40% (day 5), 51% vs. 30% (week 3), 43% vs. 20% (6 weeks), 34% vs. 13% (3 months), 25% vs. 10% (6 months) and 18% vs. 8% (1 year). Side effects were common but tolerable. Cotinine measures showed that replacement of nicotine approximated 30% of smoking levels. Hazard functions revealed relapse risks peaked at day 1, day 5 and 3 weeks for strict abstinence. It is concluded NNS is safe, efficacious and a viable alternative treatment for smoking cessation.
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