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Comparative Efficacy and Tolerability of Nicotine Replacement Therapies

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Summary

While tobacco use has declined in many industrialised nations, it remains a leading cause of preventable illness and death worldwide. Nicotine replacement therapy can play a role in assisting tobacco users to terminate their addiction. To this end, 4 different nicotine replacement therapies have been developed: (i) nicotine chewing gum (polacrilex); (ii) transdermal nicotine systems (patch); (iii) nicotine nasal spray; and (iv) nicotine inhalers.

The efficacies of these therapies have been evaluated in terms of their ability to aid smoking cessation efforts and to minimise aversive withdrawal symptoms. Tolerability has been evaluated in terms of adverse effect profiles and abuse liability. While more research evaluating the nasal spray and inhalers is needed, transdermal nicotine appears to offer the best combination of efficacy, withdrawal suppression, adverse effects and abuse liability. It has proven efficacy when used in combination with different levels of behavioural therapy.

Directions for future research include combination therapies, the most appropriate concentration of nicotine and treatment individualisation.

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Authors and Affiliations

  1. Center For Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin, 1300 University Ave, Rm 7278 MSC, Madison, Wiscinsin, 53706, USA

    Douglas E. Jorenby, Douglas S. Keehn & Michael C. Fiore

Authors
  1. Douglas E. Jorenby
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  2. Douglas S. Keehn
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  3. Michael C. Fiore
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Jorenby, D.E., Keehn, D.S. & Fiore, M.C. Comparative Efficacy and Tolerability of Nicotine Replacement Therapies. CNS Drugs 3, 227–236 (1995). https://doi.org/10.2165/00023210-199503030-00007

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