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New Smoking Cessation Tool Being Studied

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Duke Health News 919-660-1306

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.

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