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Randomised controlled trial
Nicotine patch plus lozenge gives greatest increases in abstinence from smoking rates at 6 months compared with placebo; smaller effects seen with nicotine patch alone, bupropion or nicotine lozenges alone or combined
  1. David Gonzales
  1. Correspondence to David Gonzales
    Senior Researcher and Co-Director, Smoking Cessation Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CR 115, Portland, OR 97239, USA; gonzales{at}

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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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  • Competing interests DG has received research contracts to study smoking cessation therapies from Pfizer, Nabi Biopharmaceuticals, Sanofi-Aventis and Addex Pharmaceuticals; consulting fees and honoraria for speaking to groups about smoking cessation from Pfizer; consulting fees for protocol development from Evotec Neurosciences; and reimbursements for travel expenses and meeting registrations for attending meetings relating to smoking cessation from Pfizer. DG owns five shares of Pfizer stock.