Abstract
The effect of transdermal nicotine patches on ad libitum cigarette smoking was examined in 30 subjects by measuring behavioural, biochemical and subjective aspects of smoking during a week of smoking without patches, and then a week each of nicotine and placebo patches in a randomised double blind crossover design. While wearing nicotine patches the subjects did not reduce the number of cigarettes smoked, but their expired carbon monoxide was reduced by 14%, they obtained less satisfaction from their cigarettes, and reported fewer and weaker urges to smoke. Down-regulation of nicotine intake from cigarettes was imprecise, such that when subjects wore nicotine patches their post-cigarette plasma nicotine concentration increased to an average of 45 ng/ml compared with 37 ng/ml in both no patch and placebo patch conditions. As the nicotine patches produced a plasma nicotine concentration of 15.9 ng/ml in abstinent subjects, this suggests a 22% reduction in nicotine intake from cigarettes while wearing nicotine patches. No serious symptoms of nicotine overdose were reported. It is suggested that the continuous absorption of nicotine from the patch may cause a build-up of acute tolerance to both toxic and pleasant subjective effects from smoking.
Similar content being viewed by others
References
Abelin T, Buehler A, Muller P, Vesanen K, Imhof PR (1989) Controlled trial of transdermal nicotine patch in tobacco withdrawal. Lancet 1:7–10
Benowitz NL, Jacob P (1990) Intravenous nicotine replacement suppresses nicotine intake from cigarette smoking. J Pharmacol Exp Ther 254:1000–1005
Ebert R, McNabb ME, Snow SL (1984) Effect of nicotine chewing gum on plasma levels of cigarette smokers. Clin Pharmacol Ther 5:495–498
Feyerabend C, Russell MAH (1990) A rapid gas-liquid chromatographic method for the determination of cotinine and nicotine in biological fluids. J Pharm Pharmacol 42:450–452
Jarvis MJ, Belcher M, Vesey C, Hutchinson DCS (1986) Low cost carbon monoxide monitors in smoking assessment. Thorax 41:886–887
Jones B, Kenward MG (1989) Design and analysis of cross-over trials (Monographs on statistics and applied probability no 34). Chapman and Hall, London
Kozlowski LT, Jarvik ME, Gritz ER (1975) Nicotine regulation and cigarette smoking. Clin Pharmacol Ther 17:93–97
Kumar R, Cooke EC, Lader MH, Russell MAH (1977) Is nicotine important in tobacco smoking? Clin Pharmacol Ther 21:520–529
Lucchesi BR, Schuster CR, Emley GS (1967) The role of nicotine as a determinant of cigarette smoking frequency in man with observations of certain cardiovascular effects associated with the tobacco alcaloid. Clin Pharmacol Ther 8:789–796
Porchet HC, Benowitz NL, Sheiner LB (1988) Pharmacodynamic model of tolerance: application to nicotine. J Pharmacol Exp Ther 244:231–236
Russell MAH (1978) Self-regulation of nicotine intake by smokers. In: Battig K (ed) Behavioural effects of nicotine. Karger, Basel, pp 108–122
Russell MAH (1985) Thiocyanate and nicotine half lives in plasma. Br Med J 291:217
Russell MAH (1990) Nicotine intake and its control over smoking. In: Wonnacott S, Russell MAH, Stolerman IP (eds) Psychopharmacology of nicotine. Oxford University Press, Oxford, pp 374–418
Russell MAH, Wilson C, Feyerabend C, Cole PV (1976) Effect of nicotine chewing gum on smoking behaviour and as an aid to cigarette withdrawal. Br Med J 2:391–393
Tonnesen P, Norregard J, Simonsen K, Sawe U (1990) A double-blind trial of intervention in smoking cessation using a 16-hour transdermal nicotine patch. Paper presented at the Seventh World Conference on Tobacco and Health, Perth, Western Australia, April 1990
Turner JA, Sillett RW, Taylor DM, McNicol MW (1977) The effects of supplementary nicotine in regular cigarette smokers. Postgrad Med J 53:683–686
Vesey CV, Kirk CJC (1985) Two automated methods for measuring plasma thiocyanate compared. Clin Chem 28:270–274
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Foulds, J., Stapleton, J., Feyerabend, C. et al. Effect of transdermal nicotine patches on cigarette smoking: a double blind crossover study. Psychopharmacology 106, 421–427 (1992). https://doi.org/10.1007/BF02245429
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF02245429