High-dose nicotine patch therapy: percentage of replacement and smoking cessation

Article Abstract:

Measuring a smoker's blood levels of cotinine and recording how many cigarettes they smoke may be a good way to determine what dose nicotine patch they should wear. Cotinine is a metabolite of nicotine. Researchers studied 23 light smokers, 24 moderate smokers and 24 heavy smokers. Each group was randomly assigned to one of four treatments: a placebo patch, an 11-milligram (mg) patch, a 22-mg patch or a 44-mg patch. On a 22-mg patch, only 41% of heavy smokers achieved cotinine levels high enough to replace the dose from a cigarette. Sixty-two percent of light smokers and 51% of moderate smokers achieved these levels. However, 99% of heavy smokers achieved these levels on the 44-mg patch. At 8 weeks, all of the smokers on the 44-mg were abstinent, compared to 62% of those on 22-mg patches and 59% of those on 11-mg patches. At one year, abstinence rates were still higher in those who had used the higher-dose patches.

Measurement, Dosage and administration, Cotinine

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Varying nicotine patch dose and type of smoking cessation counseling

Article Abstract:

A stronger-dose nicotine patch and intensive counseling do not appear to improve the rates of smoking cessation. Researchers assigned 252 smokers to wear a 22-milligram (mg) nicotine patch and 252 to wear a 44-mg patch for 8 weeks. In each group, one-third received a pamphlet on smoking cessation, one-third received the pamphlet plus encouragement from their physician and a follow-up letter and one-third received all of that plus group counseling. All participants returned weekly to report their success in quitting and have their urine tested for nicotine metabolites. By the 8th week, smoking cessation rates were similar in both the low-dose and high-dose group. Those in the high-dose group reported more side effects from the patch. Different counseling techniques also had little effect on smoking cessation rates. At the end of 26 weeks, only one-fourth to one-third of the smokers had successfully quit smoking.

Usage, Group counseling

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The making of a smoke-free medical center

Article Abstract:

The idea of a smoke-free medical center has only recently received broad support, despite the obvious health hazards of cigarette smoking. In 1986, the Mayo Medical Center extended its policy of restricted smoking to cover the entire center, making it the first smoke-free medical center. The methods used to develop and implement the policy included emphasizing the positive elements of smoke free environments, providing information on smoking cessation programs to staff members and their families, and thoroughly informing staff and patients prior to implementation of the policy. The Mayo Medical Center's policy met with general approval and success, as is evidenced by the smooth implementation of the smoke-free policy.

Planning, Medical centers, Prevention, Smoking, Nonsmoking areas, Mayo Clinic (Rochester, Minnesota)

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