***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 Currently available smoking cessation therapies have limited success rates . Varenicline tartrate is a novel , selective nicotinic receptor partial agonist developed specifically for smoking cessation . This study evaluated the efficacy , tolerability , and safety of 3 varenicline doses for smoking cessation . Bupropion hydrochloride was included as an active control . METHODS A phase 2 , multicenter , r and omized , double-blind , placebo-controlled study of healthy smokers ( 18 - 65 years old ) . Subjects were r and omized to varenicline tartrate , 0.3 mg once daily ( n = 128 ) , 1.0 mg once daily ( n = 128 ) , or 1.0 mg twice daily ( n = 127 ) , for 6 weeks plus placebo for 1 week ; to 150-mg sustained-release bupropion hydrochloride twice daily ( n = 128 ) for 7 weeks ; or to placebo ( n = 127 ) for 7 weeks . RESULTS During the treatment phase , the continuous quit rates for any 4 weeks were significantly higher for varenicline tartrate , 1.0 mg twice daily ( 48.0 % ; P<.001 ) and 1.0 mg once daily ( 37.3 % ; P<.001 ) , than for placebo ( 17.1 % ) . The  bupropion  rate was 33.3 % ( P = .002 vs placebo ) . The carbon monoxide-confirmed continuous quit rates from week 4 to week 52 were significantly higher in the varenicline tartrate , 1.0 mg twice daily , group compared with the placebo group ( 14.4 % vs 4.9 % ; P = .002 ) . The  bupropion rate was 6.3 % ( P = .60 vs placebo ) . Discontinuation owing to treatment-emergent adverse events was 15.9 % for bupropion , 11.2 % to 14.3 % for varenicline , and 9.8 % for placebo . No dose-related increases occurred in adverse events for varenicline . CONCLUSIONS Varenicline tartrate demonstrated both short-term ( 1 mg twice daily and 1 mg once daily ) and long-term efficacy ( 1 mg twice daily ) vs placebo . Varenicline was well tolerated and may provide a novel therapy to aid smoking cessation 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 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 Sustained-release bupropion hydrochloride and nortriptyline hydrochloride have been shown to be efficacious in the treatment of cigarette smoking . It is not known whether psychological intervention increases the efficacy of these antidepressants . This study compared both drugs with placebo . It also examined the efficacy of these 2 drugs and placebo with and without psychological intervention . METHODS This was a 2 ( medical management vs psychological intervention ) x 3 ( bupropion vs nortriptyline vs placebo ) r and omized trial . Participants were 220 cigarette smokers . Outcome measures were biologically verified abstinence from cigarettes at weeks 12 , 24 , 36 , and 52 . RESULTS Psychological intervention produced higher 7-day point-prevalence rates of biochemically verified abstinence than did medical management alone . With the use of point-prevalence abstinence , both nortriptyline and bupropion were more efficacious than placebo . On rates of 1-year continuous abstinence , the 2 drugs did not differ from each other or from placebo . Psychological intervention did not differ from medical management alone on rates of 1-year continuous abstinence . CONCLUSIONS Both nortriptyline and bupropion are efficacious in producing abstinence in cigarette smokers . Similarly , psychological intervention produces better abstinence rates than simple medical management . Both drugs , and psychological intervention , have limited efficacy in producing sustained abstinence . The data also suggest that combined psychological intervention and antidepressant drug treatment may not be more effective than antidepressant drug treatment alone 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 psychological interventions . This outcome was as good as or better than results achieved by nicotine patches using behavior modification or group counseling Background : Guidelines recommend that smoking cessation interventions are offered in all clinical setting s to all smokers willing to make a quit attempt . Since the effectiveness of routine provision of behavioural counselling and nicotine replacement therapy ( NRT ) to smokers admitted to hospital has not been established , a r and omised controlled trial of these interventions given together compared with counselling alone or minimal intervention was performed in hospital in patients . Methods : Medical and surgical in patients who were current smokers at the time of admission were r and omised to receive either usual care ( no additional advice at admission ) , counselling alone ( 20 minute intervention with written material s ) , or NRT plus counselling ( counselling intervention with a 6 week course of NRT ) .  Continuous and point prevalence abstinence from smoking ( vali date d by exhaled carbon monoxide < 10 ppm ) was measured at discharge from hospital and at 3 and 12 months , and self-reported reduction in cigarette consumption in 
    Output:
    
Adverse events were not systematic ally different across studies .
Conclusion NRT , bupropion and varenicline all provide therapeutic effects in assisting with smoking cessation .
Direct and indirect comparisons identify a hierarchy of effectiveness