Increasing nicotine intake four-fold might help smokers finally kick the bad habit, researchers say

• New research shows that smokers who want to quit the habit might find success if they increase their nicotine intake.
• The researchers say that smokers can tolerate a much larger dose (four times what is normally recommended) than that found in most nicotine replacement medications, and they’re capable of determining a dose right for themselves.
• To reach these findings, the researchers observed 50 different participants as they increased and decreased their nicotine intake over the course of 8 weeks.
• During the first 4 weeks of experimentation, the participants were encouraged to smoke as they desired; during the last 4 weeks they were instructed not to smoke at all.
• Thirty-six of the participants made it up to the maximum 84mg daily dose, and 41 made it the 4 weeks without smoking a single cigarette or experiencing any serious signs of withdrawal.
• There are several limitations of this study: the primary being that it’s the first of its kind, which demands a need for further research with a larger cohort.

Quick Summary

A new study from Queen Mary University of London “Progressive nicotine patch dosing prior to quitting smoking: feasibility, safety and effects during the pre-quit and post-quit periods,” published in Addiction, says that smokers might be more likely to succeed in shaking their smoking habit if they increase their nicotine intake. The researchers say that smokers can typically tolerate much higher doses of nicotine than those found in nicotine replacement medications and lower levels can result in the smoker resorting back to smoking.

Goals

This study sought to observe the effects of rising and falling nicotine levels—of which depended on a participant’s feedback—over the course of 8 weeks. During the first 4 weeks of the experiment the participants would continue smoking as desired, while during the last 4 weeks they would abstain. The researchers wondered how increasing the dose of nicotine from 21mg to a maximum of 84mg and then reducing it back down to 21mg over these 8 weeks might affect an individual’s attempt to quit smoking.

Investigation

In this ground-breaking experiment, researchers examined 50 different smokers who sought help with kicking this habit, in a tobacco dependence clinic in Mar del Plata, Argentina. Each participant started with a 21mg nicotine patch per day during the first week of the study, and four weeks prior to when they planned to stop smoking. This dose was increased by 21mg each week during these 4 weeks, unless the participant did not want to increase the dose or experienced ill effects from doing so.

Once the first 4 weeks were up, it was time for the participants to stop smoking. Over the course of the second 4 weeks, the dose was reduced by 21mg each week until it reached the original standard 21mg dose. During these 8 weeks, the researchers recorded several measurements including but not limited to:

• Any adverse effects
• # of participants progressing to next dosage stage
• Smoke intake during first 4 weeks
• Enjoyment of smoking during first 4 weeks
• Withdrawal symptoms

Results

The researchers found that out of the 50 participants, 36 of them made it to the 84mg dose and experienced very mild side effects such as nausea. Additionally 41 participants made it 4 weeks without smoking a single cigarette and did not experience any detectable symptoms of withdrawal. They conclude that most smokers who seek help with quitting this habit are able to tolerate higher doses of nicotine than those in the common nicotine patch. Additionally, raising the dosage may prove effective, and smokers are capable of determining the dose suitable for them.

Limitations

• This is the first study to explore the effects of customizing nicotine dosage to a smoker’s own discretion; therefore, there’s a need for further research and experimentation.
• There were only 50 participants in this study, which again stresses the need for further research and experimentation.
• Nicotine patches were the sole nicotine replacement medications; would the findings differ if other nicotine replacements were used instead?

Sources
Przulj, D., Wehbe, L., McRobbie, H., & Hajek, P. (2018, October 29). Progressive nicotine patch dosing prior to quitting smoking: feasibility, safety and effects during the pre-post and post-quit periods. Addiction. Retrieved January 3, 2019 from https://onlinelibrary.wiley.com/doi/full/10.1111/add.14483

Queen Mary University London(2019, January 2). Higher Levels of nicotine May Help Smokers Quit. NeuroscienceNews. Retrieved January 2, 2019 from http://neurosciencenews.com/nicotine-smoking-quit-10407/

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