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Nicotine patch plus lozenge appears best for smoking cessation 

In a comparison of five different smoking cessation medications, a nicotine patch plus a nicotine lozenge appears most effective at helping smokers quit, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

"Many smokers have successfully quit using a variety of smoking cessation pharmacotherapies, yet there is little direct evidence on the relative efficacies of these different pharmacotherapies," the authors write as background information in the article. "Without such evidence clinicians and smokers lack a strong empirical basis for recommending or selecting among them."

Megan E. Piper, Ph.D., of the University of Wisconsin Center for Tobacco Research and Intervention, Madison, and colleagues conducted a randomized clinical trial of smoking cessation therapies involving 1,504 adults. All had smoked at least 10 cigarettes a day during the previous six months and were motivated to quit. Participants were randomly assigned to one of six treatment groups: nicotine lozenge alone, nicotine patch alone, bupropion alone, patch plus nicotine lozenge, bupropion plus nicotine lozenge or placebo. Bupropion treatment began one week before a designated quit date and continued for eight weeks; all other treatments were taken for eight to 12 weeks after the quit date. All participants also received six individual counseling sessions.

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