Elsevier

The Lancet

Volume 340, Issue 8815, 8 August 1992, Pages 324-329
The Lancet

ORIGINAL ARTIGLES
Randomised controlled trial of nasal nicotine spray in smoking cessation

https://doi.org/10.1016/0140-6736(92)91403-UGet rights and content

Abstract

Studies with nicotine chewing gum and nicotine skin patches indicate that nicotine replacement can help people to give up smoking. The rapidity with which nicotine is absorbed when given as a nasal spray suggests that it might be effective for those for whom the other means of replacement are too slow. The efficacy and safety of a nasal nicotine spray as an adjunct to group treatment for stopping smoking were assessed in a randomised, double-blind, placebo-controlled trial in which 227 cigarette smokers attending the Maudsley Hospital Smokers Clinic received 4 weeks of supportive group treatment plus active nicotine (0·5 mg per shot) or placebo nasal spray. The main end-point was biochemically validated complete abstinence from smoking from the third week of group treatment until the 12-month follow-up. Side-effects were assessed by self-reports and, where necessary, by physical examination. Of subjects assigned to active treatment 26% (n=30) were validated abstinent throughout the year, compared with 10% (n = 11) of those assigned to placebo (relative abstinence rate 2·6, 95% Cl 1·5-4·5, p<0·001). The advantage of the active spray was greatest in the heaviest smokers. Plasma nicotine concentrations from the spray were typically between one-half and three-quarters of baseline smoking levels. Tobacco-withdrawal symptoms, craving for cigarettes, and weight gain in abstinent subjects were reduced by the active spray. Minor irritant side-effects were frequent in both active and placebo sprays, but only 2 subjects had the spray discontinued as a result. No serious adverse effects were encountered. Nasal nicotine spray combined with supportive group treatment is an effective aid to smoking cessation.

References (22)

  • T. Abelin et al.

    Controlled trial of transdermal nicotine patch in tobacco withdrawal

    Lancet

    (1989)
  • Mah Russell et al.

    A new age for snuff

    Lancet

    (1980)
  • Ph Jackson et al.

    Predictors of outcome in a General Practitioner intervention against smoking

    Prevent Med

    (1986)
  • P. Tonnesen et al.

    A double-blind trial of a 16-h transdermal nicotine patch in smoking cessation

    N Engl J Med

    (1991)
  • Transdermal Nicotine Study Group

    Transdermal nicotine for smoking cessation: six-month results from two multicenter controlled clinical trials

    JAMA

    (1991)
  • Mah Russell

    Nicotine replacement: the role of blood nicotine levels, their rate of change, and nicotine tolerance

  • G. Sutherland, Mah Russell, J. Stapleton, C. Feyerabend, O. Ferno, Nasal nicotine spray: a rapid nicotine delivery...
  • Mj Jarvis et al.

    Nasal nicotine solution as an aid to cigarette withdrawal: a pilot clinical trial

    Br J Addict

    (1987)
  • Nl Benowitz et al.

    Daily intake of nicotine during cigarette smoking

    Clin Pharmacol Ther

    (1984)
  • P. Hajek et al.

    Enhancing the impact of groups: an evaluation of two group formats for smokers

    Br J Clin Psychol

    (1985)
There are more references available in the full text version of this article.

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