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Most smoking cessation trials report efficacy of only one active medication versus placebo,1 with fewer reporting head-to-head comparisons of several active medications in the same trial.2 3 This leaves clinicians with the task of translating various reported and sometimes conflicting outcome data into reasonable treatment recommendations for patients. Piper and colleagues conducted a head-to-head study of two nicotine replacement therapies (NRTs) (patch and lozenge), bupropion, two combination therapies and placebo to provide empirical evidence for more informed clinical decisions. Their summary findings were that all the treatments studied were more effective than placebo and that combination lozenge plus patch therapy was superior to the other treatments. These findings are generally consistent with data reported in the most recent US Tobacco Dependence Clinical Practice Guideline,1 but data regarding the efficacy of the nicotine …
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