There is insufficient evidence to show that using nicotine patches for four weeks before a quit attempt (known as “preloading”) improves long-term smoking abstinence, finds a trial published by The BMJ this week.
The researchers found that nicotine preloading reduces craving intensity and seems to make quitting easier, but that this beneficial effect may have been masked by a concurrent reduction in the use of varenicline in the period after quit day. As varenicline is the most effective smoking cessation drug, this may have undermined the benefit of preloading.
If it were possible to overcome this unintended consequence, nicotine preloading “could lead to a worthwhile increase in long term smoking abstinence,” they say.
The research was funded by the National Institute for Health Research.
Although there have been several new drugs for tobacco cessation since the 1970s, treatment has remained largely the same, with behavioural support to motivate and strengthen a person’s resolve to remain abstinent and drugs to reduce the strength of urges to smoke after quit day.
Some studies have suggested that using nicotine replacement therapy before a quit attempt is more effective than when used in the conventional way to support abstinence, while other studies suggest preloading has no effect.
A research team from the UK Centre for Tobacco and Alcohol Studies, led by Professor Paul Aveyard at the University of Oxford, set out to examine the effectiveness of a nicotine patch worn for four weeks before a quit attempt. Continue reading
The Cochrane Tobacco Addiction Group (TAG) conducts and facilitates systematic reviews and meta-analyses of the research evidence for tobacco cessation and prevention interventions. The group was founded in 1996 and in 2016 they conducted a stakeholder engagement project to celebrate the 20th anniversary of TAG and to identify future research priorities for the group and the wider tobacco control community.
The objective of the project was to:
- Raise awareness of Cochrane TAG and what has been achieved so far.
- Identify areas where further research is needed in the areas of tobacco control and smoking cessation.
- Identify specific goals for Cochrane TAG
- To explore novel ways to disseminate the findings of tobacco research, and Cochrane TAG’s findings.
The survey and workshop resulted in 183 unanswered research questions in the areas of tobacco, quitting smoking and eight priority research areas, including:
- ‘addressing inequalities’
- ‘treatment delivery’
- electronic cigarettes’
- ‘initiating quit attempts’
- ‘young people’
- ‘mental health and substance abuse’
- ‘population-level interventions’
Stakeholders who attended the workshop also discussed ways that the public health community and Cochrane TAG could act to move the field of tobacco control forward.
Through this report, Cochrane TAG want to share the identified unanswered questions with the wider tobacco research community to help them to decide the most important research to focus on in the future, and to decide the most important things to work on for Cochrane TAG.
This will involve updating existing reviews, beginning reviews on new topics, and looking in more detail at Cochrane TAG’s research methods.
Contrary to popular belief there are still many important unanswered questions in the field of tobacco control. In addition, it has been noted that many of the results of tobacco control questions are not always reaching their intended targets. Tobacco control stakeholders provide a rich source of information on how these uncertainties should be prioritised; by using this resource the likelihood that the findings of research are useful and will be implemented is much greater. The project was carried out with the hope that researchers and research funders will be able to use the priorities identified to inform their future practice, in the same way that Cochrane TAG are using them to inform new review topics, updates of reviews and methods development.
Cochrane TAG’s findings and implementation suggestions should be considered alongside the existing evidence base and clinical expertise.
You can open the report and the appendices by clicking on the covers below:
Discussing the future of tobacco addiction research with the Cochrane Tobacco Addiction Group:
The CTAG taps project ran from January-December 2016. Activities carried out from April 2016-December 2016 were funded by the NIHR School for Primary Care Research (SPCR)
GRAND is a Pfizer-supported independently reviewed competitive grants program awarding individual grants of up to $200,000 from a total fund in 2017 of $1 million to support projects which directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Of 486 applications received since 2008, 62 grants have been awarded.
Pfizer has called for Clinical research proposals that aim to increase the understanding of the mechanisms of tobacco and nicotine dependence and its treatment. The overall mission of the GRAND program is to advance the pharmacological treatment of tobacco and nicotine dependence.
Each proposal should fall into one of the following areas:
- Human laboratory (e.g., pharmacokinetics, pharmacodynamics, cravings, withdrawal);
- Pharmacotherapy of smoking cessation and relapse, and / or its interaction with behavioral support;
- Characterization of subtypes of smokers; suitability for appropriate interventions.
Research projects should aim to provide information that could directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Examples could include:
- Observational or interventional studies of pharmacotherapy
- Optimization of the use of currently available medication
- Effectiveness of pharmacotherapy in real-life settings
- Development or use of new medications for cessation or harm reduction
- Specifically designed pharmacotherapy in subtypes of tobacco/nicotine users
- Use of existing databases to inform the clinical use of pharmacotherapy
- Policy interventions to increase use of pharmacotherapy.
The intent of the program is to fund at least 6 awards of between $50,000 and $200,000 in value, totaling $1.2 million. The awards are open to all investigators and they would strongly encourage applications from junior investigators.
Applications will be formally assessed by, and only by, the GRAND Review Committee, an independent committee comprising internationally prominent researchers in the field. The final responsibility for selection of Awardees rests with the Co-Chairs of the Review Committee, John Hughes and Karl Fagerstrom. The whole process is completely independent of Pfizer, including the final selection of Awardees.
GRAND is open to all investigators from around the world holding an MD, a PhD, or equivalent.
Application deadline: July 3, 2017
To apply for the grant and for more information on the application process click here!
NIHR CLAHRC East Midlands, Division of Primary Care – PhD Studentship
Applications are invited for a 3 year, full time studentship aligned to the work of NIHR CLAHRC East Midlands and the School of Medicine at the University of Nottingham. A yearly stipend at current RCUK rates (£14,296) plus Home/EU tuition fees (£4,121) is available. The successful candidate will work into the CLAHRC’s Preventing Chronic Disease (PCD) theme. Continue reading