A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies Export

@article{citeulike:6058204, abstract = {Context Little direct evidence exists on the relative efficacies of different smoking cessation pharmacotherapies, yet such evidence is needed to make informed decisions about their clinical use. Objective To assess the relative efficacies of 5 smoking cessation pharmacotherapy interventions using placebo-controlled, head-to-head comparisons. Design A randomized, double-blind, placebo-controlled clinical trial. Setting Two urban research sites. Patients One thousand five hundred four adults who smoked at least 10 cigarettes per day during the past 6 months and reported being motivated to quit smoking. Participants were excluded if they reported using any form of tobacco other than cigarettes; current use of bupropion; having a current psychosis or schizophrenia diagnosis; or having medical contraindications for any of the study medications. Interventions Participants were randomized to 1 of 6 treatment conditions: nicotine lozenge, nicotine patch, sustained-release bupropion, nicotine patch plus nicotine lozenge, bupropion plus nicotine lozenge, or placebo. In addition, all participants received 6 individual counseling sessions. Main Outcome Measures Biochemically confirmed 7-day point-prevalence abstinence assessed at 1 week after the quit date (postquit), end of treatment (8 weeks postquit), and 6 months postquit. Other outcomes were initial cessation, number of days to lapse, number of days to relapse, and latency to relapse after the first lapse. Results All pharmacotherapies differed from placebo when examined without protection for multiple comparisons (odds ratios, 1.63-2.34). With such protection, only the nicotine patch plus nicotine lozenge (odds ratio, 2.34, P < .001) produced significantly higher abstinence rates at 6-month postquit than did placebo. Conclusion While the nicotine lozenge, bupropion, and bupropion plus lozenge produced effects that were comparable with those reported in previous research, the nicotine patch plus lozenge produced the greatest benefit relative to placebo for smoking cessation. 10.1001/archgenpsychiatry.2009.142}, author = {Piper, Megan E. and Smith, Stevens S. and Schlam, Tanya R. and Fiore, Michael C. and Jorenby, Douglas E. and Fraser, David and Baker, Timothy B.}, citeulike-article-id = {6058204}, citeulike-linkout-0 = {http://dx.doi.org/10.1001/archgenpsychiatry.2009.142}, citeulike-linkout-1 = {http://archpsyc.ama-assn.org/content/66/11/1253.abstract}, citeulike-linkout-2 = {http://archpsyc.ama-assn.org/content/66/11/1253.full.pdf}, day = {1}, doi = {10.1001/archgenpsychiatry.2009.142}, journal = {Arch Gen Psychiatry}, keywords = {smoking\_cessation}, month = {November}, number = {11}, pages = {1253--1262}, posted-at = {2009-11-03 09:04:25}, priority = {2}, title = {A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies}, url = {http://dx.doi.org/10.1001/archgenpsychiatry.2009.142}, volume = {66}, year = {2009} }

TY - JOUR ID - citeulike:6058204 L3 - citeulike-article-id:6058204 N2 - Context Little direct evidence exists on the relative efficacies of different smoking cessation pharmacotherapies, yet such evidence is needed to make informed decisions about their clinical use. Objective To assess the relative efficacies of 5 smoking cessation pharmacotherapy interventions using placebo-controlled, head-to-head comparisons. Design A randomized, double-blind, placebo-controlled clinical trial. Setting Two urban research sites. Patients One thousand five hundred four adults who smoked at least 10 cigarettes per day during the past 6 months and reported being motivated to quit smoking. Participants were excluded if they reported using any form of tobacco other than cigarettes; current use of bupropion; having a current psychosis or schizophrenia diagnosis; or having medical contraindications for any of the study medications. Interventions Participants were randomized to 1 of 6 treatment conditions: nicotine lozenge, nicotine patch, sustained-release bupropion, nicotine patch plus nicotine lozenge, bupropion plus nicotine lozenge, or placebo. In addition, all participants received 6 individual counseling sessions. Main Outcome Measures Biochemically confirmed 7-day point-prevalence abstinence assessed at 1 week after the quit date (postquit), end of treatment (8 weeks postquit), and 6 months postquit. Other outcomes were initial cessation, number of days to lapse, number of days to relapse, and latency to relapse after the first lapse. Results All pharmacotherapies differed from placebo when examined without protection for multiple comparisons (odds ratios, 1.63-2.34). With such protection, only the nicotine patch plus nicotine lozenge (odds ratio, 2.34, P < .001) produced significantly higher abstinence rates at 6-month postquit than did placebo. Conclusion While the nicotine lozenge, bupropion, and bupropion plus lozenge produced effects that were comparable with those reported in previous research, the nicotine patch plus lozenge produced the greatest benefit relative to placebo for smoking cessation. 10.1001/archgenpsychiatry.2009.142 IS - 11 JF - Arch Gen Psychiatry EP - 1262 TI - A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies VL - 66 SP - 1253 KW - smoking_cessation AU - Piper, Megan AU - Smith, Stevens AU - Schlam, Tanya AU - Fiore, Michael AU - Jorenby, Douglas AU - Fraser, David AU - Baker, Timothy PY - 2009/11/01/ UR - http://dx.doi.org/10.1001/archgenpsychiatry.2009.142 ER -