Abstract
BackgroundThe prevalence of daily cigarette smoking has dropped to 10% in Hong Kong (HK) in 2017, however, smoking still kills 5700 persons per year. Studies suggest that abstinence rates are higher with combined NRT than single NRT, although local data on safety and benefits of combined NRT are lacking. The aim of this study is to compare the effectiveness of combined NRT with single NRT among HK Chinese.MethodsThis is a one-year, two-arm, parallel randomised trial. Five hundred sixty smokers, who smoked ≥10 cigarettes/day for ≥1 year, were randomized to combined and single NRT. Combined NRT group received counseling and nicotine patch & gum. Single NRT group received counselling and nicotine patch. Primary outcome was abstinence rate measured as self-reported 7-day point prevalence with CO validated at 52 weeks. Secondary outcomes included smoking abstinence rates at 4, 12, & 26 weeks. Crude odds ratio and p-value were reported from logistic regression without adjustment; for trend analysis, adjusted odds ratio (AOR) and p-value were reported from Generalized Estimating Equation (GEE) (controlling for time). All AORs were adjusted for age, sex, baseline CO and clusters.ResultsAbstinence rates at 4, 12, 26 and 52 weeks were all higher in the combined NRT group (35.8, 21.9, 16.8, 20.1%) compared with the single NRT group (28, 16.8, 11.2, 14.3%). At 4 weeks, combined NRT group was more likely to quit smoking (OR 1.43, 95% CI, 1.00 to 2.05) than the single NRT group. From GEE analysis, combined NRT group had a significantly higher abstinence rate (23.6%) than the single NRT group (17.6%) across repeated measures at all-time points. Combined NRT group was more likely to quit smoking (OR 1.43, 95% CI, 1.15 to 1.77). No significant difference in the side effect profile was detected between groups.ConclusionsSmokers given 8 weeks of combined NRT were more likely to quit smoking at 4, 12, 26 and 52 weeks compared with single NRT. Combined NRT was as well tolerated as single NRT and it should be further promoted in our community.Trial registrationNCT03836560 from ClinicalTrial.gov, 9 Feb 2019.
Highlights
The prevalence of daily cigarette smoking has dropped to 10% in Hong Kong (HK) in 2017, smoking still kills 5700 persons per year
The results of this study can further enhance the strategy in smoking cessation in Hong Kong, Key messages Smokers given 8 weeks of combined nicotine replacement therapy (NRT) had higher abstinence rates at 4, 12, 26 and 52 weeks compared with single NRT
Combined NRT was as well tolerated as single NRT and should be further promoted in smoking cessation in our community
Summary
The prevalence of daily cigarette smoking has dropped to 10% in Hong Kong (HK) in 2017, smoking still kills 5700 persons per year. Many studies [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31] had been carried out to compare the effect of monotherapy with combined nicotine replacement therapy (NRT). Several studies have shown that combined NRT is associated with lower withdrawal scores [15] and higher 6-month abstinence rates (26.9 to 36.9%) when compared with monotherapies (19 to 23%) [16,17,18,19]. Combined NRT has been shown to be as well tolerated as monotherapy [20]
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