NICOTINE NASAL SPRAY FOR SMOKING CESSATION - PATTERN OF USE, SIDE-EFFECTS, RELIEF OF WITHDRAWAL SYMPTOMS, AND COTININE LEVELS

Objective: To determine the extent of side effects during the initial use of nicotine nasal spray for smoking cessation, Design: We performe d a one-sample, noncomparative, open-label evaluation of the pattern o f use, side effects, relief of withdrawal symptoms, and cotinine level s with nicotine nasal spray, Material and; Methods: Adult smokers were recruited to use the nicotine nasal spray for smoking cessation at a dosage of I to 2 mg/h., Subjects completed daily diaries, which includ ed an assessment of nicotine withdrawal symptoms, previously reported irritant effects of the nicotine nasal spray, and symptoms of nicotine toxicity. ii plasma cotinine level was measured at baseline and at da r 7 for calculation of percentage replacement, Results: The mean age o f the 50 study subjects was 43.7 gears, 46% were women, and the mean b aseline smoking rate was 28.5 cigarettes per day. We found an increase in five symptoms (runny nose, nasal irritation, throat irritation, wa tering eyes, and sneezing) that had been essentially absent before ini tiation of use of the nicotine nasal spray, All but throat irritation decreased significantly during days 0 through 7 of the study, The mean daily frequency of nicotine nasal spray use for the first week was 15 .0 doses, Use of the nasal spray decreased significantly (P <, 0.001) during the initial 8 weeks of treatment, The mean percentage cotinine replacement for those subjects who were abstinent at day 7 was 38.6%.? , Conclusion: Although nicotine nasal spray! causes substantial irrita nt side effects during the first fen days of use, these adverse effect s decrease significantly a within the first week. Despite these side e ffects, subjects continued to use the nicotine nasal spray and experie nced a high rate of initial abstinence from smoking,.