Psychopharmacology

, 207:631 | Cite as

A randomised trial of glucose tablets to aid smoking cessation

  • Robert West
  • Sylvia May
  • Andy McEwen
  • Hayden McRobbie
  • Peter Hajek
  • Eleni Vangeli
Original Investigation

Abstract

Rationale

Oral glucose has been found to decrease tobacco craving among abstaining smokers. One study has demonstrated an effect of glucose on short-term abstinence. There is a need to examine any long-term benefit of glucose on abstinence.

Objectives

To assess whether glucose tablets improve 6-month continuous abstinence rates compared with low-calorie placebo tablets.

Methods

Smokers attempting to stop (n = 928) were randomised to receive glucose or sorbitol (placebo) in a double-blind placebo-controlled trial. All participants received group-based psychological support, and approximately half (n = 474) received nicotine replacement therapy (NRT), buproprion, or both. Smokers were seen weekly for 5 weeks and used tablets ad libitum, with a recommended minimum of 12 per day. Participants were recruited through general practitioner referral, word of mouth, and advertising. The participants were 38% male, smoked an average of 23.5 cigarettes per day, and had a mean age of 44 years. There were no significant pretreatment differences between groups. The primary outcome measure was continuous, CO-verified abstinence from the target quit date for 6 months.

Results

No significant effect of glucose tablets on abstinence was found (14.6% vs 13.4% abstinence in the glucose and placebo groups, respectively). However, there was a significant interaction with a glucose effect observed in smokers also receiving other medication (18.2% vs 12.6%, p < 0.05) but not otherwise (10.7% vs 14.3% ; p < 0.05 for the interaction).

Conclusions

No significant effect of glucose tablets over and above sweet tasting tablets could be detected overall, but the possibility of an effect as an adjunct to NRT or bupropion merits further investigation.

Keywords

Glucose Smoking cessation Tobacco Abstinence RCT 

References

  1. Berlin I, Vorspan F, Warot D, Maneglier B, Spreux-Varoquaux O (2005) Effect of glucose on tobacco craving. Is it mediated by tryptophan and serotonin? Psychopharmacology (Berl) 178:27–34CrossRefGoogle Scholar
  2. Cahill K, Stead LF, Lancaster T (2008) Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev: CD006103Google Scholar
  3. Doherty K, Kinnunen T, Militello FS, Garvey AJ (1995) Urges to smoke during the first month of abstinence: relationship to relapse and predictors. Psychopharmacology (Berl) 119:171–178CrossRefGoogle Scholar
  4. Doll R, Peto R, Wheatley K, Gray R, Sutherland I (1994) Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ 309:901–911PubMedGoogle Scholar
  5. Harakas P, Foulds J (2002) Acute effects of glucose tablets on craving, withdrawal symptoms, and sustained attention in 12-h abstinent tobacco smokers. Psychopharmacology (Berl) 161:271–277CrossRefGoogle Scholar
  6. Helmers KF, Young SN (1998) The effect of sucrose on acute tobacco withdrawal in women. Psychopharmacology (Berl) 139:217–221CrossRefGoogle Scholar
  7. Hughes JR (1992) Tobacco withdrawal in self-quitters. J Consult Clin Psychol 60:689–697CrossRefPubMedGoogle Scholar
  8. Hughes JR, Higgins ST, Bickel WK (1994) Nicotine withdrawal versus other drug withdrawal syndromes: similarities and dissimilarities. Addiction 89:1461–1470CrossRefPubMedGoogle Scholar
  9. Hughes JR, Keely J, Naud S (2004) Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 99:29–38CrossRefPubMedGoogle Scholar
  10. Hughes JR, Stead LF, Lancaster T (2007) Antidepressants for smoking cessation. Cochrane Database Syst Rev: CD000031Google Scholar
  11. Jarvik M, Olmstead R, Schnieder N, Iwamoto-Schaap P, Madsen D (1998) Sweeteners and cigarette craving: glucose, aspartame, sorbitol. Am J Health Behav 22:130–140Google Scholar
  12. Killen J, Fortmann S (1997) Craving is associated with smoking relapse: findings from three prospective studies. Exp Clin Psychopharmacol 5:137–142CrossRefPubMedGoogle Scholar
  13. Lancaster T, Stead LF (2000) Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev: CD001292Google Scholar
  14. McRobbie H, Hajek P (2004) Effect of glucose on tobacco withdrawal symptoms in recent quitters using bupropion or nicotine replacement. Hum Psychopharmacol 19:57–61CrossRefPubMedGoogle Scholar
  15. Perkins KA, Epstein LH, Stiller RL, Fernstrom MH, Sexton JE, Jacob RG, Solberg R (1991) Acute effects of nicotine on hunger and caloric intake in smokers and nonsmokers. Psychopharmacology (Berl) 103:103–109CrossRefGoogle Scholar
  16. Stead LF, Perera R, Bullen C, Mant D, Lancaster T (2008) Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev: CD000146Google Scholar
  17. West R (2001) Glucose for smoking cessation: does it have a role? CNS Drugs 15:261–265CrossRefPubMedGoogle Scholar
  18. West R, Schneider N (1987) Craving for cigarettes. Br J Addict 82:407–415CrossRefPubMedGoogle Scholar
  19. West R, Willis N (1998) Double-blind placebo controlled trial of dextrose tablets and nicotine patch in smoking cessation. Psychopharmacology (Berl) 136:201–204CrossRefGoogle Scholar
  20. West R, Courts S, Beharry S, May S, Hajek P (1999) Acute effect of glucose tablets on desire to smoke. Psychopharmacology (Berl) 147:319–321CrossRefGoogle Scholar
  21. West R, Hajek P, Stead L, Stapleton J (2005) Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction 100:299–303CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Robert West
    • 1
  • Sylvia May
    • 2
  • Andy McEwen
    • 2
  • Hayden McRobbie
    • 3
  • Peter Hajek
    • 4
  • Eleni Vangeli
    • 2
  1. 1.Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUniversity College LondonLondonUK
  2. 2.Health Behaviour Research CentreUniversity College LondonLondonUK
  3. 3.Clinical Trials Research UnitUniversity of AucklandAucklandNew Zealand
  4. 4.Wolfson Institute of Preventive MedicineBarts and the London, Queen Mary’s School of Medicine and DentistryLondonUK

Personalised recommendations