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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2014, Vol. 8 Issue (1) : 84-90     DOI: 10.1007/s11684-014-0311-9
Nicotine gum or patch treatment for smoking cessation and smoking reduction: a multi-centre study in Chinese physicians
Dan Xiao1,2,3, Nanshan Zhong4, Chunxue Bai5, Qingyu Xiu6, Canmao Xie7, Dayi Hu8, Yun Mao9, Roland Perfekt10, Elisabeth Kruse10, Qing Li11, John Jiangnan Liu9, Chen Wang1,2,3,12()
1. Beijing Chao-Yang Hospital, Capital Medical University, WHO Collaborating Center for Tobacco or Health, Beijing 100020, China; 2. Beijing Institute of Respiratory Medicine, Beijing 100020, China; 3. Department of Respiratory, Capital Medical University, Beijing 100069, China; 4. Guangzhou Institute of Respiratory Disease, 1st Affiliated Hospital, Guangzhou Medical College, Guangzhou 520120, China; 5. Zhongshan Hospital, Fudan University, Shanghai 200032, China; 6. Changzheng Hospital, 2nd Military Medical University, Shanghai 200003, China; 7. 1st Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; 8. People’s Hospital, Peking University, Beijing 100044, China; 9. Shanghai Johnson & Johnson Pharmaceuticals, Shanghai 200245, China; 10. McNeil AB, Helsingborg, Sweden; 11. Johnson & Johnson, New Jersey, USA; 12. Research Centre of Respiratory Medicine in Beijing Hospital, Ministry of Health of the People’s Republic of China, Beijing 100730, China
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In China, around 23% of physicians (41% male, 3% female) currently smoke. Pharmacotherapy for tobacco dependence is available, but is not widely used in China. The purpose of this study was to estimate the effectiveness and the safety on smoking cessation of nicotine gum and nicotine patch in Chinese healthcare professionals. Three hundred regular smokers motivated to quit were recruited from six hospitals in China. All subjects were accepted nicotine replacement therapy, and they could choose nicotine gum (2 mg or 4 mg, depending on baseline smoking level) or nicotine patch (15 mg/16 h) for 12 weeks, with a 12-week follow-up. Limited behavioural support was provided. At Week 24, the 2--24 weeks continuous abstinence rate (verified by expired carbon monoxide) was 17%, the point prevalence abstinence rate (no smoking since the previous visit) was 35%, and 38% of subjects had continuously reduced their daily cigarette consumption by at least 50% versus baseline. Compliance with treatment was good, particularly with patch. No serious adverse event was reported, and most adverse events were mild or moderate. The most common treatment-related adverse events were gastro-intestinal (both gum and patch) and local irritation symptoms. Nicotine patch and gum were well tolerated in Chinese smokers. Abstinence rates were comparable to those previously reported with nicotine replacement therapy, and many smokers who did not quit substantially reduced their cigarette consumption.

Keywords nicotine replacement therapy      smoking cessation      Chinese physicians     
Corresponding Authors: Wang Chen,   
Issue Date: 26 April 2014
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ParameterNicotine gum 2 mg(n = 86)Nicotine gum 4 mg (n = 64)Nicotine patch (n = 150)Total (n = 300)
Age (years)a40.6±10.240.3±10.041.7±11.641.1±10.9
Gender (male/female)86 / 062 / 2149 / 1297 / 3
Body mass index (kg/m2)a24.7±2.624.2±2.724.4±3.124.4±2.9
No of cigarettes smoked per daya16.5±4.429.4±8.020.2±9.721.1±9.3
Expired CO level (ppm)a17.5±8.528.0±12.420.6±11.021.3±11.3
Fagerstr?m Test of Nicotine Dependence (FTND) scorea3.5±2.06.5±2.34.4±2.54.6±2.6
Age when started smoking (years)a22.2±6.621.1±5.921.8±5.521.8±5.9
Number of previous quit attempts:
Previously used NRT or other stop-smoking medication(s):
Tab.1  Baseline demographics and smoking history for all subjects enrolled
Fig.1  Continuous CO-verified abstinence from smoking from Week 2 onwards (all subjects).
Fig.2  Point prevalence abstinence (subjects abstinent since the previous visit or telephone call).
Fig.3  Continuous CO-verified reduction in daily cigarette smoking by≥50% between baseline and Week 24 (continuous abstainers excluded).
1 Li Q, Hsia J, Yang G. Prevalence of smoking in China in 2010. N Engl J Med 2011; 364(25): 2469–2470
doi: 10.1056/NEJMc1102459 pmid:21696322
2 Chinese Center for Disease Control and Prevention. Global adult tobacco survey (GATS) China country report. Beijing: Chinese Center for Disease Control and Prevention, 2011
3 World Health Organization. World Health Organization Report on the Global Tobacco Epidemic, 2008. The MPOWER package . Geneva: World Health Organization, 2008
4 Ceraso M, McElroy JA, Kuang X, Vila PM, Du X, Lu L, Ren H, Qian N, Jorenby DE, Fiore MC. Smoking, barriers to quitting, and smoking-related knowledge, attitudes, and patient practices among male physicians in China. Prev Chronic Dis 2009; 6(1): A06
5 Jiang Y, Ong MK, Tong EK, Yang Y, Nan Y, Gan Q, Hu TW. Chinese physicians and their smoking knowledge, attitudes, and practices. Am J Prev Med 2007; 33(1): 15–22
doi: 10.1016/j.amepre.2007.02.037 pmid:17572306
6 Hsueh KC, Chen CY, Yang YH, Huang CL. Smoking cessation program in outpatient clinics of Family Medicine Department in Taiwan: a longitudinal evaluation. Eval Health Prof 2010; 33(1): 12–25
doi: 10.1177/0163278709356185 pmid:20164104
7 Lam TH, Abdullah ASM, Chan SS, Hedley AJ; Hong Kong Council on Smoking and Health Smoking Cessation Health Centre (SCHC) Steering Group. Adherence to nicotine replacement therapy versus quitting smoking among Chinese smokers: a preliminary investigation. Psychopharmacology (Berl) 2005; 177(4): 400–408
doi: 10.1007/s00213-004-1971-y pmid:15289997
8 Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008; (1): CD000146
doi: 10.1002/14651858.CD000146.pub3 pmid:18253970
9 Heatherton TF, Kozlowski LT, Frecker RC, Fagerstr?m KO. The Fagerstr?m Test for Nicotine Dependence: a revision of the Fagerstr?m Tolerance Questionnaire. Br J Addict 1991; 86(9): 1119–1127
doi: 10.1111/j.1360-0443.1991.tb01879.x pmid:1932883
10 Fiore MC, Jaén CR, Baker TB, .Guideline Panel. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline . Rockville, MD: U.S. Department of Health and Human Services. Public Health Service, 2008
11 Wennike P, Danielsson T, Landfeldt B, Westin A, T?nnesen P. Smoking reduction promotes smoking cessation: results from a double blind, randomized, placebo-controlled trial of nicotine gum with 2-year follow-up. Addiction 2003; 98(10): 1395–1402
doi: 10.1046/j.1360-0443.2003.00489.x pmid:14519176
12 Batra A, Klingler K, Landfeldt B, Friederich HM, Westin A, Danielsson T. Smoking reduction treatment with 4-mg nicotine gum: a double-blind, randomized, placebo-controlled study. Clin Pharmacol Ther 2005; 78(6): 689–696
doi: 10.1016/j.clpt.2005.08.019 pmid:16338284
13 Wang D, Connock M, Barton P, Fry-Smith A, Aveyard P, Moore D.‘Cut down to quit’ with nicotine replacement therapies in smoking cessation: a systematic review of effectiveness and economic analysis. Health Technol Assess 2008; 12(2): iii–iv , ix–xi , 1–135
14 Malaiyandi V, Sellers EM, Tyndale RF. Implications of CYP2A6 genetic variation for smoking behaviors and nicotine dependence. Clin Pharmacol Ther 2005; 77(3): 145–158
doi: 10.1016/j.clpt.2004.10.011 pmid:15735609
15 Raunio H, Rautio A, Gullstén H, Pelkonen O. Polymorphisms of CYP2A6 and its practical consequences. Br J Clin Pharmacol 2001; 52(4): 357–363
doi: 10.1046/j.0306-5251.2001.01500.x pmid:11678779
16 Ossip DJ, Abrams SM, Mahoney MC, Sall D, Cummings KM. Adverse effects with use of nicotine replacement therapy among quitline clients. Nicotine Tob Res 2009; 11(4): 408–417
doi: 10.1093/ntr/ntp005 pmid:19325134
17 Greenland S, Satterfield MH, Lanes SF. A meta-analysis to assess the incidence of adverse effects associated with the transdermal nicotine patch. Drug Saf 1998; 18(4): 297–308
doi: 10.2165/00002018-199818040-00005 pmid:9565740
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