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Does Use of Nicotine Replacement Therapy While Continuing to Smoke Undermine Cessation?: A Systematic Review

Published online by Cambridge University Press:  16 January 2013

Emma Beard ,
Paul Aveyard ,
Susan Michie ,
Ann McNeill  and
Robert West
Emma Beard*
Affiliation:
Cancer Research UK Health Behaviour Research Centre, University College London, WC1E 6BT, UK
Paul Aveyard
Affiliation:
Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
Susan Michie
Affiliation:
University College London Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
Ann McNeill
Affiliation:
UK Centre for Tobacco Control Studies, University of Nottingham, City Hospital, Nottingham, UK
Robert West
Affiliation:
Cancer Research UK Health Behaviour Research Centre, University College London, WC1E 6BT, UK
*
Address for correspondence: Emma Beard, PhD, Cancer Research UK Health Behaviour Research Centre, University College London, WC1E 6BP. E-mail: [email protected]. Tel: 020 31083179.
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Abstract

Aims: To review population surveys to assess (a) prevalence of the use of NRT for smoking reduction (SR) and temporary abstinence (TA) and (b) how far this is associated with attempts to stop smoking, smoking cessation and reduction in cigarette consumption.

Methods: An electronic search was undertaken of EMBASE, MEDLINE, Web of Science and PsycINFO. Articles were selected if they (1) assessed whether smokers had used or were currently using NRT for SR and/or TA; (2) involved smokers who had not taken part in a harm reduction programme; and (3) assessed prevalence and/or association of SR and/or TA with reductions in cigarette consumption and/or attempts to stop smoking and/or with smoking cessation. Twelve studies met the inclusion criteria and results were extracted independently by two researchers.

Results: Data were available from five countries (US, UK, Canada, Switzerland and Australia). Between 1% and 23% of smokers reported having ever used NRT for smoking reduction and between 2% and 14% during periods of temporary abstinence. Use of NRT for SR and/or TA was associated with little or no reduction in cigarette consumption. There was some evidence that it was positively associated with attempts to stop smoking and smoking cessation.

Conclusion: In smoking populations use of NRT to aid SR and in situations where smoking is not permitted appears to be having little effect on achieving a reduction in cigarette consumption but does not undermine cessation and may promote it.

Keywords

harm reductionsmoking reductiontemporary abstinenceNRT
Type
Review Article
Information
Journal of Smoking Cessation , Volume 8 , Issue 1 , June 2013 , pp. 45 - 56
Copyright
Copyright © The Authors 2013 

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References

Al-Delaimy, W., Gilpin, E. & Pierce, J. 2005. When California smokers use Nicotine Replacement Therapy, most are trying to quit smoking. Tob Control. 14, 359–360.CrossRefGoogle ScholarPubMed
Asfar, T., Ebbert, J. O., Klesges, R. C. & Relyea, G. E. 2011. Do smoking reduction interventions promote cessation in smokers not ready to quit? Addict Behav, 36 (7). 764–768.Google Scholar
Bansal, M. A., Cummings, K. M., Hyland, A. & Giovino, G. A. 2004. Stop-smoking medications: Who uses them, who misuses them, and who is misinformed about them? Nicotine Tob Res. 6 (S3), 303–310.Google Scholar
Bauer, J. E., Carlin-Menter, S. M., Celestino, P. B., Hyland, A. & Cummings, K. M. 2006. Giving away free nicotine medications and a cigarette substitute (Better Quit) to promote calls to a quitline. Public Health Manag Pract. 12 (1), 60–67.Google Scholar
Beard, E., Fidler, J. & West, R. 2011b. Is use of Nicotine Replacement Therapy while continuing to smoke associated with increased nicotine intake? Psychopharmacol. 218 (3), 609–610.Google Scholar
Beard, E., McNeill, A., Aveyard, P., Fidler, J., Michie, S. & West, R. 2011a. Use of Nicotine Replacement Therapy for smoking reduction and during enforced temporary abstinence: A national survey of English smokers. Addiction. 106 (1), 197–204.Google Scholar
Beard, E., McNeill, A., Aveyard, P., Fidler, J., Michie, S. & West, R. in press. Associations between smokers’ attempts at harm reduction and smoking cessation: A prospective study of English smokers. Tob Control.Google Scholar
Berg, C. J., An, L. C., Kirch, M., Guo, H., Thomas, J. L., Patten, C. A., Ahluwalia, J. S. & West, R. 2010. Failure to report attempts to quit smoking. Addict Behaviors. 35 (10), 900–904.Google Scholar
Botello-Harbaum, M., Schroeder, J. R., Collins, C. C. & Moolchan, E. T. 2010. Nicotine Replacement Therapy use among adolescent smokers seeking cessation treatment. Ethn Dis. 20 (2), 180–184.Google Scholar
Cummings, K. M. & Hyland, A. 2005. Impact of Nicotine Replacement Therapy on smoking behaviour. Annu Rev Public Health. 26 (1), 583–589.Google Scholar
Cummings, K. M., Hyland, A., Giovino, G. A., Hastrup, J. & Bauer, J. 2004. Are smokers adequately informed about the health risks of smoking and medicinal nicotine? Nicotine Tob Res. 6 (S3), 333–340.CrossRefGoogle ScholarPubMed
Curry, S. J., Grothaus, L. C., McAfee, T. & Pabiniak, C. 1998. Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organisation. New Engl J Prev Med. 339, 673–679.Google Scholar
Emmons, K.M., Goldstein, M. G., Roberts, M., Cargill, B., Sherman, C. B., Millman, R., Brown, R. & Abrams, D. B. 2000. The use of Nicotine Replacement Therapy during hospitalization. Ann Behav Med. 22 (4), 325–329.Google Scholar
Etter, J-F., le Houezec, J. & Landfeldt, B. 2003. Impact of messages on concomitant use of Nicotine Replacement Therapy and cigarettes: A randomised trial on the internet. Addiction. 98, 941–950.Google Scholar
Fagerstrom, K. O. 2005. Can reduced smoking be a way for smokers not interested in quitting to actually quit? Respiration. 72 (2), 216–220.Google Scholar
Fagerstrom, K. O. & Hughes, J. R. 2002. Nicotine concentrations with concurrent use of cigarettes and nicotine replacement: A review. Nicotine Tob Res. 4 (S2), 73–79.Google Scholar
Hajek, P., West, R., Foulds, J., Nilsson, F., Burrows, S. & Meadow, A. 1999. Randomized Comparative trial of nicotine polacrilex, a transdermal patch, nasal spray, and an inhaler. Arch Intern Med. 159, 2033–2038.Google Scholar
Hammond, D., Reid, L., Driezen, P., Cummings, M., Borland, R., Fong, G. T., McNeill, A. & Hughes, J. R. 2008. Smokers’ use of Nicotine Replacement Therapy for reasons other than stopping smoking: Findings from the ITC Country Survey. Addiction. 103, 1696–1703.Google Scholar
Higgins, J. & Green, S. 2008. Cochrane Handbook for Systematic Reviews of Interventions. Oxford, UK: Wiley.Google Scholar
Horne, R. & Weinman, J. 1999. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 47 (6), 555–567.Google Scholar
Hughes, J. R., 2000. Reduced smoking: An introduction and review of the evidence. Addiction. 104 (12), 2088–2099.Google Scholar
Hughes, J. R., Adams, E. H., Franzon, M. A., Maguire, M. K. & Guary, J. 2005. A prospective study of off-label use of, abuse of, and dependence on nicotine inhaler. Tob Control. 14, 49–54.CrossRefGoogle ScholarPubMed
Hughes, J. R. & Carpenter, M. J., 2006. Does smoking reduction increase future cessation and decrease disease risk? A qualitative review. Nicotine Tob Res. 8 (6), 739–749.CrossRefGoogle ScholarPubMed
Hughes, J. R., Lindgren, P. G., Connett, J. E. & Nides, M. A. 2004. Smoking reduction in the lung health study. Nicotine Tob Res. 6 (2), 275–280.Google Scholar
Hughes, J. R., Pillitteri, J. L., Callas, P. W., Callahan, R. & Kenny, M. 2004. Misuse of and dependence on over-the-counter nicotine gum in a volunteer sample. Nicotine Tob Res. 6 (1), 79–85.Google Scholar
Johnson, R E., Stevens, V. J., Hollis, J. F. & Woodson, G. T. 1992. Nicotine chewing-gum use in outpatient care setting. JFP. 34, 61–65.Google Scholar
Kotz, D., Fidler, J. & West, R. 2009. Factors associated with the use of aids to cessation in English smokers. Addiction. 104 (8), 1403–1410.Google Scholar
Levy, D. E., Thorndike, A. N., Biener, L. & Rigotti, N. 2007. Use of Nicotine Replacement Therapy to reduce or delay smoking but not to quit: Prevalence and association with subsequent cessation efforts. Tob Control. 16, 384–389.CrossRefGoogle Scholar
Miller, N., Frieden, T. R., Liu, S. Y., Matte, T. D., Mostashari, F., Deitcher, D. R., Cummings, K. M., Chang, C., Bauer, U. & Bassett, M. T. 2005. Effectiveness of a large-scale free nicotine patch distribution program. The Lancet. 365, 1849–1854.Google Scholar
Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. G. 2009. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ. 339, 2535.Google Scholar
Moore, D., Aveyard, P., Connock, M., Wang, D., Fry-Smith, A. & Barton, P., 2009. Effectiveness and safety of Nicotine Replacement Therapy assisted reduction to stop smoking: Systematic review and meta-analysis. BMJ. 338, 1024.Google Scholar
Shahab, L., Cummings, M., Hammond, D., Borland, R., West, R. & McNeill, A. 2009. The impact of changing nicotine replacement therapy licensing laws in the United Kingdom: finding from the International Tobacco Control Four Country Survey. Addiction. 104, 1420–1427.Google Scholar
Shiffman, S., Feguson, S. G., Rohay, J. & Gitchell, J. G. 2008. Perceived safety and efficacy of nicotine replacement therapies among US smokers and ex-smokers: Relationship with use and compliance. Addiction. 103, 1372–1379.Google Scholar
Shiffman, S., Hughes, J. R., Di Marino, J. R. & Sweeney, C. T. 2003. Patterns of over the counter nicotine gum use: Persistent use and concurrent smoking. Addiction. 98 (12), 1747–1753.Google Scholar
Stead, L. F. & Lancaster, T., 2007. Interventions to reduce harm from continued tobacco use. Cochrane Database Systematic Reviews. 2, CD005231.Google Scholar
Thorndike, A. N., Biener, L. & Rigotti, N. A. (2002). Effect on smoking cessation of switching nicotine replacement therapy to over-the-counter status. Am J Public Health, 92 (3), 437–442.Google Scholar
Tonnesen, P. 2002. Smoking reduction for smokers not able or motivated to quit? Respiration. 69 (6), 475–478.CrossRefGoogle ScholarPubMed
Wang, D., Connock, M., Barton, P., Fry-Smith, A., Aveyard, P. & Moore, D., 2008. Cut down to quit with nicotine replacement therapies in smoking cessation: A systematic review of effectiveness and economic analysis. HTA. 12 (2), 1–135.Google Scholar
Zellweger, J. P. 2001. Anti-smoking therapies: Is harm reduction a viable alternative to smoking cessation? Drugs. 61, 1041–1044.Google Scholar
Zhu, S. H, Melcer, T. M., Sun, J., Rusbrook, B. & Pierce, J. P. 2000. Smoking cessation without and with assistance: A population based analysis. Am J Prev Med. 18, 305–311.Google Scholar