***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Subjects ( N = 139 ) were assigned to intensive behavioral or to low-contact smoking treatment and to 2-mg nicotine gum or to placebo gum in a 2 X 2 factorial design . The 2-mg gum produced higher abstinence rates than did the placebo . Subjects receiving the low-contact condition plus the 2-mg nicotine gum had excellent abstinence rates at both 26 weeks ( 56 % abstainers ) and 52 weeks ( 50 % abstainers ) . Smokers who scored at the median on a measure of physical dependence to nicotine were more likely to benefit by nicotine gum treatment than subjects who scored either higher or lower , but this relation was nonsignificant . The results of this study are compared with an earlier nonblind trial BACKGROUND This study was conducted to determine the efficacy of the nicotine patch in smoking cessation when combined with self-help material s , three brief visits , and telephone counseling . METHODS One hundred fifty-nine healthy volunteers who smoked at least one pack of cigarettes per day and desired to quit smoking were enrolled in a double-blind trial with 6-week treatment and 6-month follow-up periods . After review of self-help material s , subjects were r and omly assigned to regimens of nicotine or placebo patches . Subjects wore two patches per day for 4 weeks ( 25 mg of nicotine per 24 hours ) , then one patch per day for 2 weeks . Return visits were at the ends of weeks 4 and 6 . Telephone counseling was given during weeks 1 , 2 , 3 , and 5 . Abstinence at 6 weeks was defined as zero cigarettes smoked for the previous 28 days , verified by exhaled carbon monoxide less than 8 ppm at 4 weeks and 6 weeks . Abstinence at 3 and 6 months was defined as self-report of zero cigarettes since the previous contact , verified by carbon monoxide value at 6 months . RESULTS Abstinence rates at 6 weeks , 3 months , and 6 months were 29.5 % , 21.8 % , and 20.5 % in the active group , and 8.8 % , 3.8 % , and 2.5 % in the placebo group ( P < or = .001 for each comparison ) , respectively . Skin irritation was the main side effect , causing 1.3 % to drop out . CONCLUSION The nicotine patch is efficacious in smoking cessation over a 6-month period , when combined with only self-help material s , three brief visits , and telephone counseling The use of nicotine chewing gum combined with psychological support improves the success rate in stopping smoking . We studied the safety and efficacy of a transdermal nicotine patch in stopping smoking . We conducted a double-blind r and omized study comparing the effect of a 16-hour nicotine patch ( 15 + /- 3.5 mg of nicotine in 16 hours ) with those of a placebo patch . Of the 289 smokers ( 207 women and 82 men ) enrolled in the study , 145 were treated with nicotine patches and 144 with placebo patches for 16 weeks . The rates of sustained abstinence were significantly better with active treatment than with the placebo : 53 , 41 , 24 and 17 % of those in the nicotine-patch group were abstinent after 6 , 12 , 26 , and 52 weeks , respectively , as compared with 17 , 10 , 5 and 4 % of those in the placebo-patch group ( p less than 0.0001 ) . Only two subjects with the nicotine patch and one with the placebo patch withdrew from the study because of side effects . The nicotine skin patch proved to be safe and effective , as demonstrated by a higher rate of abstinence than with the placebo Sixty subjects were run in a study comparing the use of nicotine gum with placebo gum  during cessation from smoking . Subjects were given clinic support and chewed the gum ad libitum . A survival analysis showed the two groups differed significantly in successful abstinence over time ( p less than .03 ) . Differences between groups appeared early ( within weeks ) and , at six months , a 28 % superiority of nicotine over placebo gum was demonstrated with mean success rates of 48 % and 20 % , respectively . Between six months and one year , relapse in the nicotine group accounted for the 30 % vs. 20 % success rates for nicotine and placebo observed at one year . In a pilot study ( " dispensary " ) testing the efficacy of the two gums when intervention was minimal , subjects in both groups resumed smoking within the first two weeks . The enhanced short-term success rates with nicotine gum in the clinic study are attributed to an effective interaction between use of the active preparation and clinic support . Long-term cessation may require extended maintenance procedures and /or an identification of optimal gum use AIMS To evaluate the efficacy and safety of orally administered naltrexone , alone or in combination with nicotine patches , as a treatment for cigarette smoking .  DESIGN R and omized , partially-blinded , 2 x 2 factorial trial using naltrexone ( active vs. placebo ) and nicotine patches ( active vs. none ) . PARTICIPANTS One hundred cigarette smokers . INTERVENTION Twelve weeks of either placebo-only , naltrexone-only , placebo with nicotine patches or naltrexone with nicotine patches . The naltrexone dose was 50 mg taken once daily , and the nicotine patch dose was 21 mg/24-hour for the first 8 weeks and 14 mg/24-hour for the remaining 4 weeks . Brief behavioral intervention was provided at each visit . MEASUREMENTS One-week point-prevalence smoking abstinence rates confirmed by an expired air carbon monoxide level of 8 parts per million ( ppm ) or less , daily cigarette smoking and cigarette craving . FINDINGS At the end of treatment , there was no effect of naltrexone on smoking abstinence . The smoking abstinence rates were 19 % and 22 % for the placebo only and naltrexone only treatment groups , respectively , and 48 % and 46 % for the placebo with nicotine patch and naltrexone with nicotine patch groups , respectively . However , the effect of the nicotine patch at this time was significant ( p = 0.006 ) , but not at the 6-month follow-up . No significant effect of naltrexone was observed on daily cigarette smoking on cigarette craving during the study . CONCLUSIONS The opioid antagonist naltrexone was not found to be effective for smoking cessation and had no significant effect on daily cigarette consumption or craving . The results of the present study provide no support for the use of naltrexone , alone or in combination with nicotine patches , as a therapeutic treatment for smoking cessation A non-combustible nicotine inhaler , administered orally , has been developed for treatment of smokers . The inhaler allows weaning from nicotine while maintaining partial reinforcement of the ritual/sensory phenomena of smoking . Subjects were r and omly assigned to  active ( n = 112 ) and placebo ( n = 111 ) groups . Some behavioral intervention occurred as a function of participation . Strict abstinence ( primary outcome criterion ) was defined by CO < or = 8 ppm with no slips allowed at any time and cotinine values < or = 14 at 1 year . Survival analysis showed active inhaler was superior to placebo ( p < 0.01 ) . Active vs. placebo  success rates were : 63 % vs. 47 % ( day 3 ) , 46 % vs. 28 % ( week 1 ) , 36 % vs. 19 % ( week 2 ) , 33 % vs. 16 % ( week 3 ) , 29 % vs. 14 % ( week 6 ) , 24 % vs. 10 % ( 3 months ) , 17 % vs. 9 % ( 6 months ) and 13 % vs. 8 % ( 1 year ) . chi 2 analyses were significant through 3 months but not at 6 months ( p < 0.08 ) or 1 year . Craving was relieved with active inhalers at day 3 and week 1 . Subjects averaged six inhalers/day . Cotinine levels were 57 - 61 % of smoking levels . Common side effects included throat/mouth irritation and coughing . Failure was predicted by early slips . The inhaler is clearly useful for short-term smoking cessation with potential for long-term efficacy . Extended access to the inhaler and relapse prevention training could improve success rates . Another promising approach would be to combine the inhaler with a nicotine patch BACKGROUND Smoking is considered as an addiction to nicotine for most subjects consuming 10 cigarettes or more per day . Hence , nicotine replacement therapy by way of gum , patch , or spray has been advocated . The rationale of this study is to evaluate the possible beneficial effects of adding nicotine gum to the routine of subjects using the nicotine patch .  The effect of the nicotine patch against the placebo , both groups receiving placebo nicotine gum , has also been assessed . METHODS Healthy subjects ( 374 ) were r and omized at their work- setting in a 1-year double-blind placebo-controlled trial : 149 subjects to active nicotine patch + active gum ( group 1 ) , 150 to active nicotine patch + placebo gum ( group 2 ) , and 75 to placebo patch + gum ( group 3 ) . Treatment duration was 12 weeks with a 16-hr transdermal patch of 15 mg , followed by a 6 + 6-weeks weaning period on respectively 10 and 5 mg patches . Gum use was not restricted during the first 6 months , with recommendations to use at least four pieces a day . A strict definition of smoking abstinence was used in this study , which did not allow smoking any cigarette after Week 1 .  Nonsmoking status at each visit , as reported by the subjects , was verified by CO below 10 ppm in expired air . RESULTS Abstinence rates in group 1 against group 2 were 34.2 and 22.7 % ( P = 0.027 ) at 12 weeks , 27.5 and 15.3 % ( P = 0.010 ) at 24 weeks , and 18.1 and 12.7 % ( P = 0.191 ) at 52 weeks . In group 3 , abstinence rates were 17.3 , 14.7 , and 13.3 % respectively at 12 , 24 , and 52 weeks . Using logistic regression with adjustment for six baseline covariates , odds ratios for abstinence ( with 95 % CI ) were computed . For group 1/group 2 , OR at 12 , 24 , and 52 weeks were 1.72 ( 1.03 - 2.94 ) ( P = 0.039 ) , 2.04 ( 1.14 - 3.57 ) ( P = 0.018 ) , and 1.47 ( 0.76 - 2.76 ) ( P = 0.125 ) . No significant differences in OR were observed when comparing groups 2 and 3 . Time to relapse is significantly longer in group 1 as compared to that of group 2 ( P = 0.041 ) , whereas no significant differences between groups 2 and 3 were observed . No significant differences between the three groups in systemic and local adverse drug events were observed . CONCLUSION Adding active gum use to active patch use in subjects smoking 10 cigarettes or more a day increased abstinence rates , which are statistically significant up to 24 weeks BACKGROUND To determine the effectiveness of a 16-hour transdermal nicotine patch in assisting smokers to stop smoking , when used in a primary medical practice model . METHODS A single-site , r and omized , double-blind , out-patient , parallel-group , placebo-controlled trial consisting of 220 regular , otherwise healthy cigarette smokers . Patients participated in a 12-week patch treatment phase plus a 6-week tapering phase . A st and ard medical office model of physician intervention , such as could easily be employed by any primary care physician , without need for any special psychological services , training , or skills , was the behavioral intervention . RESULTS Sustained abstinence , determined at each visit by absolutely no cigarette use , carbon monoxide level of 9 ppm or less , and serum cotinine level of 15 ng/mL or less ( after week 18 ) , was significantly greater for those patients receiving the active nicotine patch than for those receiving the placebo patch : the percent of patients not smoking at 6 , 12 , 18 , 26 , and 52 weeks was 61 % vs 35 % , 45 % vs 26 % , 41 % vs 16 % , 34 % vs 12 % , and 25 % vs 9 % , respectively ( P < .001 ) . This 16-hour nicotine patch produced no systemic side effects and minimal skin irritation . CONCLUSIONS Nicotine replacement therapy via a 16-hour transdermal nicotine patch provided safe and effective treatment for tobacco-dependent patients . One-year sustained nonsmoking rates were nearly three times higher in the active than in the placebo condition , when the patch was used in an easily applicable st and ard medical practice setting , without the need for 
    Output:
    
There is no strong evidence that combinations of forms of NRT are more effective .
In this study , bupropion was significantly more effective than nicotine patch or placebo .
The combination of bupropion and nicotine patch was significantly more effective than nicotine patch alone .
REVIEW ER 'S CONCLUSIONS All of the commercially available forms of NRT ( nicotine gum , transdermal patch , the nicotine nasal spray , nicotine inhaler and nicotine sublingual tablets ) are effective as part of a strategy to promote smoking cessation .
The effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the smoker .
Since all the trials of NRT reported so far have included at least some form of brief advice to the smoker , this represents the minimum which should be offered in order to ensure its effectiveness .
Provision of more intense levels of support , although beneficial in facilitating the likelihood of quitting , is not essential to the success of NRT .
There is promising evidence that bupropion may be more effective than NRT ( either alone or in combination ) .