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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 1:30 PM

Gradual Cessation Via NRT: New Data on Efficacy, Acceptability and UK Implementation

John Hughes, MD1, Erica Peters, BA1, Robert West, PhD2, and Saul Shiffman, PhD3. (1) Psychiatry, University of Vermont, 38 Fletcher Pl, Burlington, VT 05401-1419, (2) Epidemiology and Public Health, University College London, 2-16 Torrington Place, London, WC1E 6BT, United Kingdom, (3) Department of Psychology, University of Pittsburgh, 130 N. Bellefield Ave (Suite 510), Pittsburgh, PA 15213

Objective: To learn a) how interested smokers are in gradual cessation, b) the efficacy of NRT-assisted gradual cessation and c) the rationale and outcome of the recent UK approval of gradual cessation

Methods: We present several studies addressing the use of NRT for cessation by gradual reduction. Three US surveys examined interest in gradual cessation. A multi-site clinical trial randomized US smokers trying to quit gradually (n=3297) to active vs placebo nicotine gum. The UK approved use of NRT for gradual reduction in the fall of 2005; data on rationale for approval and use of NRT for this indication will be presented.

Results: Among a sample of US smokers planning on quitting in the next month, 83% reported that they planned to do so gradually. US smokers are as interested, if not more interested, in gradual vs. abrupt cessation and do not fear using NRT to aid in this. Smokers on active nicotine gum (vs. placebo) reduced more prior to quitting, had higher 6 mo quit rates (OR = 2.9) and had no significant adverse events. Preliminary results of the effect of implementation of this cessation method in the UK will be reviewed.

Conclusions: In scientific studies, gradual cessation is attractive to smokers and is efficacious when aided by NRT. Evaluation data from the UK will begin to test whether this holds true during real-world implementation. If so, gradual reduction may be an important new option for smokers who have not responded to abrupt cessation interventions.