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Hum Psychopharmacol. 2008 Aug;23(6):513-7. doi: 10.1002/hup.947.

Comparison of craving and withdrawal among four combination nicotine treatments.

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Nicotine Dependence Research Unit, Veteran Affairs Greater Los Angeles (VAGLA) Healthcare System, Los Angeles, California 90073, USA.



To assess the appearance of craving and withdrawal among four combination nicotine replacement treatments (NRTs).


In a crossover trial of NRT preferences, 27 smokers tested 4 combinations of nicotine treatments: 2 mg/4 mg gums + 15 mg patch, 2 mg/4 mg lozenges + 15 mg patch, inhalers + 15 mg patch, and 10 + 15 mg double patch (approximately 25 mg). Overnight abstinence was required prior to (1/2) day testing of each combination. Combination NRTs were used for approximately 6 h/day. Subjects resumed smoking each afternoon. For this report, we used the Smoker Anchored Withdrawal Grid to look at craving and withdrawal scores over 5 days of testing (smoking baseline + four treatment days).


"Urge to smoke" and "total withdrawal" showed a rise from baseline to NRT use for the double patch but not for the three acute + patch conditions. Lozenge/patch scores did not rise from baseline for "craving" and "miss a cigarette" but did for gum/patch, inhaler/patch, and double patch. The best relief occurred for NRTs of choice.


This was a small but suggestive finding regarding the potential of patch plus adjunct ad lib NRT. With little data on relief with NRT combinations, more systematic tests are needed.

[Indexed for MEDLINE]

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