Smokers are more than twice as likely to quit if they use the nicotine patch along with nicotine lozenges—compared to lozenges or patches alone, buproprion (Xyban), buproprion plus the lozenges or placebo. The trial was the largest study ever to compare these approaches head to head, and included 1,504 smokers.
All of the treatment groups did better than placebo—but the effect was strongest for the patch/lozenge combination, 40% of whom successfully kicked the habit. Smokers using this combo were not only more likely to quit, but also less likely to have a “slip” prompt a return to regular smoking.
The study adds support to a growing body of research that suggests that offering addicts access to drugs similar to their drug of choice—or even that drug itself —can actually help them quit or at least dramatically reduce the harm associated with their addiction.
Placing this in the context of offering drug replacements to addicts is interesting food for thought. One important bit of context is that these were people who were trying to quit and the overarching goal of helping professionals with smokers is to try to help them quit, not reduce use. The nicotine addicts I know want full recovery. They want to be completely smoke free, and the few people I know who have been on nicotine replacement for years still really want to stop but can't. The system encourages their moves toward quitting completely and supports gradual change. That seems to be an important part of any lessons drawn from treatment for nicotine addiction. The focus of heroin maintenance is not to stabilize people while moving them toward quitting, it's to maintain them because we've concluded that they can't quit.