People who want to quit smoking have higher odds of success if they use a nicotine patch plus a fast-acting form of nicotine replacement therapy (NRT), such as gum, lozenge, or nasal spray, according to a new Cochrane Review.
This review includes 63 trials covering 41,509 participants. All studies were conducted in people who wanted to quit smoking, and most were conducted in adults. People who enrolled in the studies typically smoked at least 15 cigarettes a day at the start of the studies. Studies lasted for at least six months. The evidence is up to date to April 2018.
Using nicotine patches and another type of NRT (such as gum or lozenge) together made it 15% to 36% more likely that a person would successfully stop smoking than if they used one type of NRT alone. People were also more likely to quit successfully if they used higher‐dose nicotine patches (containing 25 mg (worn over 16 hours) or 21 mg (worn over 24 hours) of nicotine compared to 15 mg (worn over 16 hours) or 14 mg of nicotine (worn over 24 hours)) or higher‐dose nicotine gum (containing 4 mg of nicotine compared to 2 mg of nicotine). Using NRT before a quit day as well as after may help more people to quit than only using it after, but more evidence is needed to strengthen this conclusion. However, people who smoke have the same chances of quitting successfully whether they use a nicotine patch to quit or another type of NRT, such as gum, lozenge or nasal spray. Study withdrawals due to treatment were higher in patients using nicotine nasal spray and higher-dose patches.
Most studies did not look at safety. Where studies did look at safety, very few people experienced negative effects of NRT. Evidence from another review shows that NRT is a safe medication. the authors caution that more data are needed.
Read the Cochrane review here.
Source: NEJM Journal Watch & Cochrane Library
