DURHAM, N.C. -- Combining two smoking cessation therapies is more effective than using just one for male and highly nicotine-dependent smokers who weren't initially helped by the nicotine patch, according to researchers at Duke Medicine.
The findings, published online June 17, 2014, in the American Journal of Psychiatry, also support using an adaptive treatment model to determine which smokers are likely to succeed in quitting with nicotine replacement alone before trying additional therapies.
"The findings offer a potential practical treatment approach that can identify smokers who don't respond to a single conventional treatment, but may benefit enormously from a combination of treatments," said Jed Rose, Ph.D., director of the Duke Center for Smoking Cessation and the study's lead author.
Rose and his colleagues have developed adaptive models for smoking cessation that tailor treatment regimens based on a person's likelihood of successfully quitting. Smokers start using a nicotine patch prior to quitting, and based on their reduction in smoking, researchers then determine who is likely to successfully quit with or without additional treatments.
"Using a safe and inexpensive nicotine patch, we can predict a smoker's success or failure," Rose said. "If a smoker has a low likelihood of succeeding, we can avert failure before it happens using a step-by-step algorithm to switch a smoker to a treatment that's more likely to help."
Current smoking cessation treatments including nicotine replacement, bupropion (sold under the brand name Zyban) and varenicline (sold as Chantix) have modest long-term success rates. Research has shown that less than 25 percent of smokers remain abstinent a year after treatment.
"It's clear that we need to improve success rates for smoking cessation, and it is thought that combining treatments could add to the efficacy," Rose said. "Combining two therapies, especially if
|Contact: Rachel Harrison|
Duke University Medical Center