Nicotine spray
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Nicotine Spray for Smoking Cessation: Efficacy, Safety, and User Preferences
Introduction to Nicotine Spray for Smoking Cessation
Nicotine replacement therapy (NRT) has been a cornerstone in aiding smoking cessation. Among various forms of NRT, nicotine sprays, both nasal and mouth, have shown promise due to their rapid nicotine absorption, which can quickly alleviate withdrawal symptoms and cravings.
Efficacy of Nicotine Nasal Spray
Randomized Controlled Trials
Several studies have demonstrated the efficacy of nicotine nasal spray in smoking cessation. A randomized, double-blind, placebo-controlled trial involving 227 smokers found that 26% of participants using the active nasal spray remained abstinent for a year, compared to 10% in the placebo group, with the greatest benefit observed in heavy smokers. Another study with 157 participants showed that the abstinence rates at 6 weeks, 3 months, and 6 months were significantly higher in the nicotine group compared to the placebo group. Additionally, a study involving 255 smokers reported that the nasal spray significantly enhanced success rates at various intervals up to one year.
Short-Term Effects
Short-term studies also support the efficacy of nasal nicotine spray. For instance, a study evaluating the effects of short-term nasal spray nicotine replacement found that it significantly suppressed the desire to smoke and reduced the number of cigarettes smoked.
Efficacy of Nicotine Mouth Spray
Long-Term Efficacy
Nicotine mouth sprays have also been shown to be effective. A multicenter, randomized, double-blind, placebo-controlled study with 479 smokers reported higher continuous abstinence rates for the active spray group at 6, 24, and 52 weeks compared to the placebo group. Another study in a naturalistic setting confirmed these findings, showing significant treatment effects throughout a 26-week period.
User Preferences and Short-Term Effects
A pilot study comparing nicotine mouth spray, gum, and inhalers found that 54% of participants preferred the spray, although it was associated with a higher rate of local adverse effects. Additionally, a randomized clinical trial demonstrated that the nicotine mouth spray provided faster relief of cravings compared to nicotine lozenges.
Safety and Adverse Effects
Nasal Spray
The safety profile of nicotine nasal spray is generally acceptable, with most side effects being minor irritations. In the study with 227 participants, minor irritant side effects were frequent but only led to discontinuation in two cases, and no serious adverse effects were reported. Another study noted that while side effects were common, they were tolerable, and the spray was deemed safe.
Mouth Spray
Nicotine mouth sprays also have a generally acceptable safety profile, though they are associated with a higher incidence of local adverse effects such as burning sensations, nausea, and hiccups . In a large study, the severity of adverse events was similar between the active and placebo groups, with most events being mild or moderate.
Conclusion
Both nicotine nasal and mouth sprays are effective aids for smoking cessation, offering rapid relief from cravings and withdrawal symptoms. While nasal sprays have shown significant long-term efficacy, mouth sprays are preferred by many users despite their higher rate of local adverse effects. Overall, these nicotine sprays provide valuable options for smokers seeking to quit, with their efficacy and safety well-supported by multiple studies.
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