Matching high-dependence and low-dependence smokers to self-help treatment with or without nicotine replacement

Background. This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence. Methods. One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association. Results. Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant. Conclusion. The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.