Hollands, GJ;
Sutton, S;
Aveyard, P;
(2022)
The effect of nicotine dependence and withdrawal symptoms on use of nicotine replacement therapy: Secondary analysis of a randomized controlled trial in primary care.
Journal of Substance Abuse Treatment
, 132
, Article 108591. 10.1016/j.jsat.2021.108591.
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Abstract
INTRODUCTION: Nicotine replacement therapy (NRT) is effective for smoking cessation, but the optimal method of using NRT to maximize benefit is unclear. We examined whether nicotine dependence was associated with consumption of NRT, whether this was mediated by withdrawal symptoms, and the impact of these factors on cessation, in a population advised to use as much NRT as needed. METHODS: Secondary analysis of data from an open label, parallel group randomized controlled trial. Participants (n = 539) attended a smoking cessation clinic in primary care and remained engaged with treatment for at least one week following a quit attempt. Baseline dependence was measured by the Fagerström Test for Cigarette Dependence (FTCD), with tobacco exposure assessed via an exhaled carbon monoxide test. At one week after quit day, mean daily consumption of NRT was measured for all participants; withdrawal (Mood and Physical Symptoms Scale (MPSS)) was also assessed in the subsample who reported being completely abstinent to that point (n = 279). Abstinence was biochemically assessed at four weeks for all participants as the principal smoking cessation outcome. RESULTS: Each point higher on the FTCD was associated with 0.83 mg/day more NRT consumption, controlling for tobacco exposure. This relationship was diminished when withdrawal was controlled for, and withdrawal was associated with NRT consumption, with each point higher on the MPSS associated with a 0.12 mg/day increase. Increased consumption of NRT directly predicted subsequent smoking cessation. CONCLUSIONS: Higher dependence appears to lead to greater withdrawal, which appears to drive greater use of NRT. This effect may partly offset lower abstinence rates in people with higher dependence. Advice to use sufficient NRT to suppress withdrawal may increase abstinence rates.
| Type: | Article |
|---|---|
| Title: | The effect of nicotine dependence and withdrawal symptoms on use of nicotine replacement therapy: Secondary analysis of a randomized controlled trial in primary care |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jsat.2021.108591 |
| Publisher version: | https://doi.org/10.1016/j.jsat.2021.108591 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Abstinence, Adherence, Dependence, Nicotine replacement therapy, Smoking cessation, Withdrawal, Humans, Nicotine, Nicotinic Agonists, Primary Health Care, Smoking Cessation, Substance Withdrawal Syndrome, Tobacco Use Cessation Devices, Tobacco Use Disorder |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10159846 |
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