NICOTINE PATCH THERAPY FOR SMOKING CESSATION IN RECOVERING ALCOHOLICS

In a post hoc analysis of prior nicotine patch studies, we analysed fi ndings in 357 subjects (43 recovering alcoholics, 314 non-alcoholics) to determine if recovering alcoholic smokers were more nicotine depend ent than non-alcoholics and whether the efficacy of nicotine patch the rapy was comparable. The Self-Administered Alcoholism Screening Test w as used to identify recovering alcoholics. Recovering alcoholics had s ignificantly higher mean smoking rates (cigarettes per day), Fagerstro m scores and baseline serum nicotine and cotinine than non-alcoholics. Among a subset of 240 subjects with a comparable treatment protocol, smoking cessation rates at the end of nicotine patch therapy were simi lar in recovering alcoholics (46%) and non-alcoholics (47%) receiving active 22 mg patches bur higher than the respective placebo groups (17 % and 19%). The 1-year rate was significantly (p = 0.005) higher in th e non-alcoholic group assigned to an active patch (31%) compared to pl acebo (14%). For recovering alcoholics, the rates were lower and not s ignificantly different (active 0%, placebo 11%). Recovering alcoholic smokers are likely to be more nicotine dependent than non-alcoholic sm okers but can achieve comparable short-term cessation rates with nicot ine parch therapy. Use of an objective, validated measure of alcohol d ependence is indicated in clinical trials when it is desirable to know whether the subjects are active or recovering alcoholics.