A Solution
For Smokers
 mokers
may eventually have another available tool—an oral nicotine solution
that can be added to their favorite beverage—to help them kick
the habit, according to Eric C. Westman, assistant professor in the
department of medicine at Duke Medical Center.
Westman and colleagues said the nicotine solution can
be added to coffee, tea, soda, beer, lemonade, or other beverages
and consumed orally several times a day in lieu of smoking. The solution
was patented in April. After conducting a successful study of twenty-five
smokers who used the solution, the researchers are seeking a pharmaceutical
company to fund larger clinical trials.
“One of the advantages of the oral solution is that
it involves a hand-to-mouth action, similar to that of smoking,”
Westman says. “Also, the nicotine is metabolized fairly rapidly,
providing a quicker nicotine boost than is provided by a nicotine
patch. And unlike nicotine gum, which comes in regular, mint, and
orange flavors, the oral solution can be flavored in almost any way
the smoker chooses to flavor it.”
Results of the small pilot study will be published later
this year.
Smokers in the study chose a “smoking quit date”
and were given vials of the solution to mix into their beverages with
instructions to use it as needed for smoking urges during a twelve-week
period. The taste of the solution is masked by the beverage that is
used. Participants consumed anywhere from 2.5 milligrams to 10 milligrams
of the solution per drink. Three milligrams consumed orally is close
to the one milligram amount of nicotine typically acquired by smoking
a cigarette.
Westman says abstinence rates reported by the participants
at four weeks, three months, and six months were 28 percent, 24 percent,
and 20 percent, respectively. He says these rates are typical of most
of the smoking-intervention tools currently available. Participants
received only minimal behavioral counseling during the study.
Side effects from using the oral solution were minimal
in the twenty-five participants studied. The only participant to drop
out of the study complained of a burning sensation at the site of
dental work.
“Nicotine-replacement therapy is the most widely
used pharmacologic treatment for smoking cessation,” according
to Westman. “It is thought to work by reducing withdrawal symptoms,
or by separating the rewarding aspects of nicotine from the behavior
of smoking.” Besides the patch and nicotine gums, the other forms
of nicotine replacement available are the nasal spray, oral inhaler,
a lozenge, and sublingual tablets.
“There are 435,000 deaths per year in the United
States from cigarette smoking,” he adds. “Obviously, we
must continue to research various methods of smoking cessation to
provide as much assistance as we can to help people quit.”
Early research has shown that nicotine also may be useful
for patients with ulcerative colitis, attention deficit disorder,
and Alzheimer’s disease. If further research supports the benefits
of nicotine in these patients, having a variety of methods for administering
nicotine will be helpful, Westman says.
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