Combination Pharmacotherapy Helps Ill Smokers Quit
Combination of nicotine patch, nicotine inhaler and bupropion nearly doubles odds of success
TUESDAY, April 7 (HealthDay News) -- Smokers with medical conditions are significantly more likely to become abstinent with flexibly dosed triple combination pharmacotherapy than with standard-duration nicotine patch therapy. In addition, smokers on pharmacotherapy who are intensively managed may be more likely to quit, according to two studies published in the April 7 issue of the Annals of Internal Medicine.
In one study, Michael Steinberg, M.D., of the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School in New Brunswick, N.J., and colleagues randomly assigned 127 smokers with predefined medical illnesses to receive either a nicotine patch alone for 10 weeks, or a combination of a nicotine patch, nicotine oral inhaler and bupropion as needed. After 26 weeks, they found that 35 percent of the combination-treatment group achieved smoking abstinence compared to 19 percent of the nicotine patch-alone group.
In a second study, Edward Ellerbeck, M.D., of the University of Kansas Medical Center in Kansas City, and colleagues randomly assigned 750 smokers to receive either pharmacotherapy alone, pharmacotherapy with up to two counseling calls or pharmacotherapy with up to six counseling calls every six months. After two years, the overall analyses showed an association between higher-intensity disease management and improved smoking cessation rates.
"This intervention design is feasible in a general medical practice and is consistent with the latest guidelines, which suggests combination pharmacotherapy as first-line treatment of tobacco dependence," Steinberg and colleagues conclude.