Nicotine replacement therapy enables a significant number of patients with chronic obstructive pulmonary disease (COPD) to stop smoking, according to a report in the August issue of Chest, Reuters reported. "Nicotine replacement therapy works in COPD," Dr. Philip Tnnesen from Gentofte Hospital, Hellerup, Denmark, told Reuters Health. "And nicotine replacement therapy works in smokers of fewer than 10 cigarettes per day. I believe this is the first study ever to show this." COPD is a group of serious lung diseases that include emphysema and chronic bronchitis. It is primarily caused by smoking. Tnnesen and colleagues compared the efficacy of nicotine replacement combined with high- or low-behavioral support for smoking cessation in 370 patients with COPD who smoked an average of about 19 cigarettes daily. The use of under-the-tongue nicotine tablets was associated with an approximate doubling of abstinence rates compared with placebo at 6 (23 percent versus 10 percent) and 12 months (17 percent versus 10 percent), respectively, the authors report. However, the intensity of behavioral support did not significantly influence the outcomes. "The good thing from our design is that both the interventions used seem to be effective," Tnnesen said. Neither nicotine replacement nor behavioral support significantly influenced smoking reduction among patients who continued to smoke after 6 or 12 months, the results indicate. Smoking cessation was associated with a significant increase in lung function, the investigators say, whereas lung function remained stable among those who reduced their smoking but deteriorated among those who continued smoking at their baseline rate. Adverse events occurred at similar rates in the nicotine and placebo groups and in the high- and low-behavioral support groups. "We must get our COPD patients to quit smoking," Tnnesen said, adding "smoking cessation should be an integral part of therapy for patients who smoke with respiratory disease."
