QuitNic: A Pilot Randomised Controlled Trial Comparing Nicotine Vaping Products with Nicotine Replac
Friday, August 14, 2020
Posted by: Natalia Gromov
Bonevski B, Manning V,
Wynne O, et al.
QuitNic: A Pilot
Randomised Controlled Trial Comparing Nicotine Vaping Products with Nicotine
Replacement Therapy for Smoking Cessation following Residential Detoxification.
[published online ahead of print, 2020 Aug 8]. Nicotine Tob Res. 2020;ntaa143.
doi:10.1093/ntr/ntaa143
Introduction:
The QuitNic pilot trial aimed to test the feasibility of providing a nicotine
vaping product (NVP) compared with combination nicotine replacement therapy
(NRT) to smokers upon discharge from a smoke-free residential substance use
disorder (SUD) treatment service.
Methods: QuitNic
was a pragmatic two-arm randomised controlled trial. At discharge from
residential withdrawal, 100 clients received telephone Quitline behavioural
support and either 12-weeks supply of NRT, or an NVP. Treatment adherence and
acceptability, self-reported abstinence, cigarettes smoked per day (CPD),
frequency of cravings, and severity of withdrawal symptoms, were assessed at
6-weeks and 12-weeks. Results are reported for complete cases and for
abstinence outcomes, Penalized Imputation results are reported where missing is
assumed smoking.
Results: Retention
was 63% at 6-weeks and 50% at 12-weeks. At 12-weeks, 68% of the NRT group
reported using combination NRT while 96% of the NVP group used the device.
Acceptability ratings for the products were high in both groups. At 12-weeks, 14%
of the NVP group and 18% of the NRT group reported not smoking at all in the
last 7 days. Mean CPD among continued smokers decreased significantly between
baseline to 12-weeks in both groups; from 19.91 to 4.72 for the NVP group
(p<0.001) and from 20.88 to 5.52 in the NRT group (p<0.001). Cravings and
withdrawal symptoms significantly decreased for both groups.
Conclusion: Clients
completing residential withdrawal readily engaged with smoking cessation
post-treatment when given the opportunity. Further research is required to
identify the most effective treatments post-withdrawal for this population at
elevated risk of tobacco-related harm.
Implications: This
pilot study showed that smoking cessation support involving options for
nicotine replacement and Quitline-delivered cognitive behavioural counselling
is attractive to people after they have been discharged from SUD treatment.
Both nicotine vaping products and nicotine replacement therapies were highly
acceptable and used by participants who reported reductions in cravings for
cigarettes and perceptions of withdrawal symptoms and reductions in number of
cigarettes smoked. Some participants self-reported abstinence from cigarettes -
around one in five reported having quit smoking cigarettes at 12-weeks post-discharge.
The results have significant public health implications for providing quit
support following discharge from SUD treatment.
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