Background: Currently-marketed smoking cessation drugs reportedly lack high levels of efficacy and are inadequate at addressing the behavioural component of tobacco dependence. Nicotine free inhalators are plastic devices that may provide a coping mechanism for conditioned smoking cues by replacing some of the rituals associated with smoking gestures. The present study assessed for the first time the effect of using a nicotine free inhalator to improve success in a standard smoking cessation program.
Method: At baseline, 120 healthy smokers attending a smoking cessation program (pharmacological treatment with high dose nicotine patch plus 300 mg·day−1 bupropion and counseling) were assessed for their sociodemographic factors, smoking history, subjective ratings of depression (by Beck Depression Inventory; BDI), physical dependence (by FTND), behavioural dependence (by Glover-Nilsson Smoking Behavioural Questionnaire; GN-SBQ) and motivation (by Mondor Motivational Questionnaire). Participants were randomly assigned into two groups (nicotine free inhalator - PAIPO group vs reference group) and asked to attend two further follow-up visits at week-4 and week-24 during which abstinence from cigarette smoking was subjectively and objectively reviewed.
Results: Of the 120 participants , 90 (75.0%) and 85 subjects (70.8%) completed the follow-up visit at week-4 and week-24 respectively. For the whole sample, no significant difference was found in quit rates between PAIPO (33.3%; week-24) and reference group (28.3%; week-24). However, the quit rate in PAIPO group (66.7%; week-24) was more than three-fold higher compared with the reference group (19.2%; week-24) for those individuals with high GN-SBQ scores at baseline. The results of the logistic model analysis indicate that a high GN-SBQ score is a strong independent predictor for successful quitting at week-24 (OR = 8.88; 95%CI = 2.08-37.94) in the PAIPO users.
Conclusion: Nicotine free inhalators may be beneficial when used in the context of smoking cessation interventions, particularly for those smokers for whom handling and manipulation of their cigarettes play an important part of the ritual of smoking and likely to have a strong behavioural component of their tobacco dependence.