Quitting with more nicotine

Allowing smokers to determine their nicotine intake while they are trying to quit is likely to help them kick their habit, according to a EurekAlert story citing a study of 50 people led by Queen Mary University of London.

The results of the first study to tailor nicotine dosing based on the choices of smokers trying to quit suggest that most smokers who use stop-smoking medications can easily tolerate doses that are four times higher than those normally recommended.

Study author Dunja Przulj of Queen Mary University of London said that smokers determined their nicotine intake while they smoked, but that when they tried to quit their nicotine levels were dictated by the recommended dosing of the treatment. “These levels may be far too low for some people, increasing the likelihood that they go back to smoking,” Przulj said.

“Medicinal nicotine products may be under-dosing smokers and could explain why we’ve seen limited success in treatments, such as patches and gum, helping smokers to quit. A change in their application is now needed.

“Our findings should provide reassurance to smokers that it is okay to use whatever nicotine doses they find helpful.”

When nicotine replacement treatment was first evaluated in the 1970s, low doses were used because of concerns about toxicity and addictiveness. Evidence then emerged that nicotine on its own, outside of tobacco products, has limited addictive potential, and that higher doses are safe and well tolerated. Despite this, stop-smoking medications have maintained lower nicotine levels in their products.

The new study, published in the journal Addiction, examined 50 smokers in a tobacco dependence clinic in Argentina, and was the first to try a combined approach of ‘pre-loading’ nicotine prior to the quit date, and tailoring nicotine levels based on patient feedback.