Individual differences in preferences for and responses to four nicotine replacement products

Rationale: With several different forms of nicotine replacement therapy ava ilable for smokers, it is useful to know about factors that may influence c hoice of form. Objective: To examine factors associated with preference for different nicotine replacement products and effectiveness of these product s. The simple comparison of success rates between the products has been rep orted previously. Methods: Five hundred and four smokers were invited to ra nk order four products (gum, patch, nasal spray and inhaler) in terms of pr eference and were then randomly allocated to receive one of the products fo r a smoking cessation attempt. They were followed up 1 week, 4 weeks, 12 we eks and 15 weeks later. Ratings of the products were repeated I week after the quit date. Mood and physical symptoms were assessed at baseline and at each follow-up visit. Urges to smoke were assessed at all post-quit date se ssions. Abstinence was assessed by self-report with expired air carbon mono xide verification. Results: The patch was the most popular product initiall y, followed by the spray and inhaler and then the gum. The difference was g reater for women than men. However, all smokers quickly came to like whiche ver product they had been allocated. Smokers who initially preferred the sp ray or inhaler were heavier smokers than those who preferred the gum or pat ch. Prior experience of the gum was associated with lower initial preferenc e for it, but did not affect outcome. Prior experience with the patch had n o effect on preference or outcome. Being allocated to the preferred product did not increase success at stopping smoking. Women were more successful a t stopping smoking on the inhaler than the gum. Among highly dependent smok ers, those on the inhaler had a lower relapse rate than those on the other products. Conclusions: Regardless of initial preferences, whether patients obtain their preferred form of NRT or one selected for them did not seem to affect outcome. This may be because smokers came to like particular produc ts as they got used to them. Other things being equal, women may be better advised to use inhaler rather than gum and men vice versa.