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Little Evidence Nicotine Preloading Helps Smokers Quit

Adjustment for varenicline use as a post-cessation treatment linked to increase in beneficial effect


THURSDAY, June 14, 2018 (HealthDay News) -- Nicotine preloading does not significantly increase subsequent smoking abstinence in adult daily smokers with tobacco dependence, according to a study published online June 13 in The BMJ.

Paul Aveyard, Ph.D., from the University of Oxford in the United Kingdom, and colleagues conducted a randomized open label trial involving 1,792 adults who were daily smokers with tobacco dependence. Participants were randomized to either the control arm (893 participants) and received standard smoking cessation pharmacotherapy and behavioral support or to the preloading arm (899 adults) who received the same treatment supplemented by four weeks of 21-mg nicotine patch use before quitting.

The researchers found that biochemically validated abstinence at six months was achieved by 17.5 and 14.4 percent of participants in the preloading and control arms, respectively (odds ratio, 1.25; 95 percent confidence interval [CI], 0.97 to 1.62; P = 0.08 in the primary analysis). After adjustment for use of varenicline as a post-cessation treatment, the odds ratio for the effect of preloading was 1.34 (95 percent CI, 1.03 to 1.73; P = 0.03). The odds ratio for the difference in prolonged abstinence at four weeks was 1.21 (95 percent CI, 1.00 to 1.48) in analyses unadjusted for varenicline use, and 1.32 (95 percent CI, 1.08 to 1.62) in analyses adjusted for varenicline.

"Evidence was insufficient to confidently show that nicotine preloading increases subsequent smoking abstinence," the authors write.

GlaxoSmithKline donated nicotine patches to the National Health Service (NHS) in lieu of NHS treatment costs.

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