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Randomised controlled trial
Nicotine patch plus lozenge gives greatest increases in abstinence from smoking at 6 months compared with placebo; smaller effects seen with nicotine patch alone, bupropion or nicotine lozenges alone or combined
  1. Lynne Buchanan
  1. Correspondence to Lynne Buchanan
    Associate Professor, University of Nebraska Medical Center College of Nursing, 985330 Nebraska Medical Center CON, Omaha, NE 68198-5330, USA; lbuchanan{at}unmc.edu

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The US Public Health Service recommends five nicotine replacement therapy (NRT) products and two non-nicotine medications (bupropion and varenicline).1 The NRT products are the most commonly used medications in clinical settings.2 Bupropion and varenicline, although relatively safe and effective, have recent black box warnings and enhanced surveillance recommendations for patients with mental health problems, making the NRT products alone or in combination a more appealing drug of choice.3 Piper and colleagues' study is important because there have been few head-to-head comparisons of the effectiveness of these first-line medications, in particular the nicotine patch plus nicotine lozenge.

This was a well-designed, longitudinal, randomised placebo-controlled clinical trial examining a selection …

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