VCU news

By Lorraine Cichowski and Thomas Eissenberg

RICHMOND, Va. - Low-dosage nicotine patches appear to be as effective as higher-dose patches in suppressing withdrawal symptoms when smokers stop smoking, according to preliminary research presented today (Feb. 19) by Virginia Commonwealth University.

 

The findings, presented at the annual meeting of the Society for Research on Nicotine and Tobacco in Scottsdale, AZ, raise questions about whether the common practice of suggesting that smokers start a smoking cessation program with the highest-dose nicotine patch is the right strategy, or whether it exposes smokers to unnecessarily high levels of nicotine without added benefit.

 

"Our data so far are showing that the higher doses are not necessarily better at suppressing withdrawal, at least over the short-term," says Thomas Eissenberg, Ph.D., associate professor of psychology and head of VCU's Clinical Behavioral Pharmacology Laboratory.

 

Eissenberg and his colleagues studied 66 smokers between the ages of 18 and 55 who reported smoking at least 15 "king size" or "100s" cigarettes daily for the past two years. On different days they tested each smoker with one of four different doses of nicotine patches - 0 mg, 7 mg, 21 mg and 42 mg. The patches are applied to the skin like an adhesive bandage and release small but constant amounts of nicotine into the body to help smokers relieve some of the withdrawal symptoms they typically experience when they quit smoking.

 

In four, 6.5-hour sessions, the researchers measured heart rate and blood nicotine levels as well as smokers' reports of withdrawal symptoms, such as cigarette cravings and smoking urges.

 

They found that smokers who used the higher-dose patches had higher heart rates and levels of nicotine in their blood. However, there was very little difference in levels of cravings for cigarettes when smokers were given 7 mg, 21 mg or 42 mg patches, although higher levels of cravings were observed when smokers were given 0 mg patches. 

 

"There's no doubt that the nicotine in the patches is doing something," Eissenberg said. "Nicotine is suppressing craving overall, and that's good. But just piling on nicotine after nicotine may not be the most effective method of helping smokers quit. We need to do something else, like behavioral treatments, in addition to nicotine to help smokers deal with their withdrawal and address all other aspects of quitting."

 

Eissenberg's team is continuing the study on the effectiveness of nicotine patch doses and plans to increase the sample size to 128 heavy smokers. 

 

This study is funded by the National Institute on Drug Abuse.