New Smoking Cessation Tool Being Studied
        
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DURHAM, N.C. - Smokers may eventually have another available
    tool – an oral nicotine solution that can be added to their
    favorite beverage – to help them kick the habit, according to
    Dr. Eric C. Westman, assistant professor in the department of
    medicine at Duke University Medical Center.
Westman and colleagues said the nicotine solution can be
    added to coffee, tea, soda, beer, lemonade or other beverages
    and consumed orally several times a day in lieu of smoking. The
    solution was patented (#6,211,194) April 3 in the United
    States. After conducting a successful study of 25 smokers who
    used the solution, the researchers now are seeking a
    pharmaceutical company to fund larger clinical trials.
"One of the advantages of the oral solution is that it
    involves a hand-to-mouth action, similar to that of smoking,"
    Westman said. "Also, the nicotine is metabolized fairly
    rapidly, providing a quicker nicotine boost than is provided by
    a nicotine patch. And unlike nicotine gum, which comes in
    regular, mint and orange flavors, the oral solution can be
    flavored in almost any way the smoker chooses to flavor
    it."
Results of the small pilot study will be published later
    this year.
Smokers in the study chose a "smoking quit date" and were
    given vials of the solution to mix into their beverages with
    instructions to use it as needed for smoking urges during a
    12-week period. The taste of the solution is masked by the
    beverage that is used. Participants consumed anywhere from 2.5
    milligrams to 10 milligrams of the solution per drink. Three
    milligrams consumed orally is close to the one milligram amount
    of nicotine typically acquired by smoking a cigarette.
Westman said abstinence rates reported by the participants
    at four weeks, three months and six months were 28 percent, 24
    percent and 20 percent, respectively. He said these rates are
    typical of most of the smoking-intervention tools currently
    available. Participants received only minimal behavioral
    counseling during the study.
Side effects from using the oral solution were minimal in
    the 25 participants studied. The only participant to drop out
    of the study complained of a burning sensation at the site of
    dental work.
"Nicotine-replacement therapy is the most widely used
    pharmacologic treatment for smoking cessation," said Westman.
    "It is thought to work by reducing withdrawal symptoms, or by
    separating the rewarding aspects of nicotine from the behavior
    of smoking. Besides the patch and nicotine gums, the other
    forms of nicotine replacement available are the nasal spray,
    oral inhaler, a lozenge and sublingual tablets.
"There are 435,000 deaths per year in the United States from
    cigarette smoking," he added. "Obviously, we must continue to
    research various methods of smoking cessation to provide as
    much assistance as we can to help people quit."
Early research has shown that nicotine also may be useful
    for patients with ulcerative colitis, attention deficit
    disorder and Alzheimer's disease. If further research supports
    the benefits of nicotine in these patients, Westman said having
    a variety of methods for administering nicotine will be
    helpful.
The other patent awardees were Jed Rose and Keith Tomlin of
    Duke.