Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jan;86(1):132-9.
doi: 10.1016/j.pbb.2006.12.017. Epub 2007 Jan 4.

Effects of high dose transdermal nicotine replacement in cigarette smokers

Dorothy Hatsukami  1 , Marc Mooney, Sharon Murphy, Mark LeSage, David Babb, Stephen Hecht
Affiliations

Effects of high dose transdermal nicotine replacement in cigarette smokers

Dorothy Hatsukami et al. Pharmacol Biochem Behav. 2007 Jan.

Abstract

Rationale: Nicotine replacement therapies (NRT) have been evaluated to facilitate cigarette smoking reduction in smokers unwilling or unable to quit. In most of these studies, only conventional doses of NRT have been tested and higher doses may be required to result in significant reductions in smoking and in biomarkers of exposure.

Objective: To determine if higher NRT doses in conjunction with smoking are safe and may promote significant reductions in cigarette smoking and biomarkers of exposure.

Methods: A dose-ranging, within-subject design was implemented to evaluate the effects of 15, 30 and 45 mg nicotine-patch treatment on measures of safety and the extent of smoking reduction and biomarker exposure per cigarette in smokers (N=20 completers) not immediately interested in quitting.

Results: Concurrent smoking and NRT were generally tolerated and resulted in no changes in blood pressure or heart rate. Slightly less than 10% of the study sample was not given the highest dose of NRT due to side effects. Self-reported cigarette smoking decreased with increasing doses of nicotine replacement and significant reductions were observed for total NNAL (a carcinogen biomarker) and carbon monoxide. However, even at the 45 mg dose, increased carbon monoxide and total NNAL per cigarette occurred, even though cotinine levels increased on average, 69.3% from baseline.

Conclusions: The present results suggest that the use of high dose NRT is safe, leads to significant reductions in smoking (-49%), significant but less reductions in total NNAL (-24%) and carbon monoxide (-37%) due to compensatory smoking.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study design and timeline. The study occurred in three phases: baseline, treatment (dose-escalation and escalation), and follow-up. For analytic purposes, only the baseline and treatment phases were evaluated.
Figure 2
Figure 2
Percentage reduction in smoking at week 5 (45 mg dose) and exposure ratios for carbon monoxide and total NNAL at week 5 across subjects. Mean reduction at week 5 was -48.9%, while mean ERs for carbon monoxide and total NNAL at week 5 were respectively, M = 2.45 (SD = 2.54) and M = 1.66 (SD = 1.09).
See this image and copyright information in PMC

References

    1. Benowitz NL, Jacob P., 3rd Intravenous nicotine replacement suppresses nicotine intake from cigarette smoking. J Pharmacol Exp Ther. 1990;254(3):1000–5. - PubMed
    1. Benowitz NL, Zevin S, Jacob P., 3rd Suppression of nicotine intake during ad libitum cigarette smoking by high-dose transdermal nicotine. J Pharmacol Exp Ther. 1998;287(3):958–62. - PubMed
    1. Bolliger CT, Zellweger JP, Danielsson T, van Biljon X, Robidou A, Westin A, et al. Smoking reduction with oral nicotine inhalers: double blind, randomised clinical trial of efficacy and safety. Bmj. 2000;321(7257):329–33. - PMC - PubMed
    1. Carpenter MJ, Hughes JR, Solomon LJ, Callas PW. Both smoking reduction with nicotine replacement therapy and motivational advice increase future cessation among smokers unmotivated to quit. J Consult Clin Psychol. 2004;72(3):371–81. - PubMed
    1. Etter JF, Laszlo E, Zellweger JP, Perrot C, Perneger TV. Nicotine replacement to reduce cigarette consumption in smokers who are unwilling to quit: A randomized trial. Journal of Clinical Psychopharmacology. 2002;22(5):487–95. - PubMed

Publication types

MeSH terms