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How much does relapse after one year erode effectiveness of smoking cessation treatments? Long term follow up of randomised trial of nicotine nasal spray

BMJ 1998; 316 doi: (Published 14 March 1998) Cite this as: BMJ 1998;316:830
  1. John A Stapleton, senior lecturer (,
  2. Gay Sutherland, lecturer,
  3. Michael A H Russell, professor
  1. Institute of Psychiatry, Tobacco Research Section, National Addiction Centre, London SE5 8AF
  1. Correspondence to: Dr Stapleton
  • Accepted 8 July 1997

Recent research on treatments to stop smoking has focused almost entirely on nicotine replacement, and several meta-analyses testify to the efficacy of four delivery systems.1 Although the ultimate goal of treatment is lifelong cessation, few trials have published results of abstinence beyond one year. Little consideration has therefore been given to whether the treatment is effective in reducing the major health risks of smoking. This effect would become evident only after many years of abstinence. Our randomised trial showed that the use of nicotine nasal spray compared with a placebo spray was associated with more than double the number of abstainers at one year.2 We report the results from a longer term follow up to estimate the impact of relapse after one year on effectiveness.

Subjects, methods, and results

A total of 227 heavy smokers entered the trial; 116 were given …

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