(How much does relapse after one year erode effectiveness of smoking cessation treatments? Long term follow up of randomised trial of nicotine nasal spray)
Recent research on treatments to stop smoking has focused almost entirely on nicotine replacement and the effectiveness of different types of product. Even though the ultimate goal of treatment is that patients give up smoking for the rest of their lives, few trials have looked into the results of abstinence beyond one year.
In this week's BMJ, Stapleton et al consider the effectiveness of nicotine nasal sprays and estimate relapse to smoking in the longer term. In their study of 227 heavy smokers, the authors found that 47 abstained from smoking for one year - 33 used a nicotine nasal spray, whilst 14 used a product with a placebo effect. Within two years nearly a quarter (23 per cent) of these abstainers had relapsed to smoking and nearly half (48 per cent) had returned to the weed within three and a half years.
Over the longer term, Stapleton et al found that patients using the nicotine nasal spray were two and a half times more likely to quit smoking for longer than a year, than those using the placebo. However, high relapse rates after one year (similar to relapse rates to nicotine patches and gum) indicate that one year's success rates overestimate long term cessation and therefore overstate the advantages to health in the long run.
Contact:
Dr John Stapleton, Senior Lecturer, Institute of Psychiatry, Tobacco Research Section, National Addiction Centre, London j.stapleton@iop.bpmf.ac.uk
or
Gay Sutherland, Senior Clinical Psychologist g.sutherland@iop.bpmf.ac.uk