Introduction:
This text is a summary of a clinical trial investigating the effectiveness of pre-cessation nicotine replacement therapy (NRT) on smoking abstinence at 6 months. The trial aimed to determine if using NRT patches and/or gum for two weeks prior to the target quit day, followed by usual care, would result in higher quit rates compared to usual care alone. The study was conducted in New Zealand, with 1100 adult, dependent smokers who called the New Zealand quitline for support to quit smoking.
Key Points:
* The trial was a pragmatic randomized controlled trial conducted in New Zealand.
* Participants were randomly assigned to receive pre-cessation NRT (patches and/or gum) for two weeks prior to their target quit day and usual care (8 weeks of patches and/or gum plus support calls from a quitline adviser), or to usual care alone.
* The primary outcome was self-reported 7-day point prevalence smoking abstinence 6 months after quit day.
* Secondary outcomes included continuous abstinence, cotinine-verified abstinence, daily cigarette consumption, withdrawal symptoms, and adverse events.
* Six months after quit day, 125 participants (22.7%) in the pre-cessation group and 116 participants (21.0%) in the control group reported 7-day point prevalence abstinence, indicating no significant difference between the groups.
* however, when pooled in a meta-analysis with other pre-cessation trials, a moderate benefit of about a one-quarter increase in cessation rates was evident.
* There was no difference in adverse events between groups.
Main Message:
In summary, this large, pragmatic trial found that using NRT patches and/or gum for two weeks prior to the target quit day did not significantly improve quit rates compared to usual care alone. however, when combined with previous pre-cessation trials, there appears to be a moderate benefit. Pre-cessation NRT is safe and well-tolerated but did not offer any significant benefit in this study. Further research is needed to enhance our understanding of cessation strategies with greater efficacy and broader appeal.
