SERUM NICOTINE AND COTININE LEVELS DURING NICOTINE-PATCH THERAPY

We related serum nicotine and cotinine levels while subjects were smok ing their usual numbers of cigarettes to levels while wearing a nicoti ne patch under carefully controlled, smoke-free conditions in a clinic al research center. Twenty-four volunteers who needed intensive treatm ent for severe nicotine dependence were admitted to the clinical resea rch center and were treated with a 22 mg transdermal nicotine patch ea ch day and an intensive smoking-cessation program. Serum nicotine and cotinine levels, withdrawal symptoms, and hours and quality of sleep w ere noted. The steady-state serum nicotine and cotinine levels produce d with the nicotine patch were lower than those observed when the subj ects were smoking. Mean nicotine and cotinine levels were inversely re lated to mean withdrawal scores for the first 6 days. A fixed dose of transdermal nicotine will not be effective for all smokers. Individual ization of therapy should be based on objective biologic measures such as serum cotinine and subjective assessment of withdrawal relief.