A BOOST IN STAYING SMOKE-FREE

Patch-Spray Combination Helps

LONDON - Smokers who used a combination of a nicotine patch and
nasal spray nearly doubled their chances of staying smoke-free for six
years, compared to those who used a patch alone, a new study says.

The research by scientists in Iceland -- which involved the longest
follow-up of any such study to date -- showed that 16 percent of those
who used the combination did not smoke for six years, compared to 8.5
percent of those who relied only on a patch.

``Smoking is such a large-scale problem that even at an 8 percent
improvement, it would have a massive impact on death rates,'' said
John Stapleton, a smoking expert at London's Institute of Psychiatry
who was not involved in the study.

In the study, published in this week's British Medical Journal,
scientists at the National University Hospital in Reykjavik enrolled
237 smokers in a program to help them quit.

All were given nicotine patches, while half were given nicotine nasal
spray and half a placebo spray. The subjects used the spray and
patches for five months and continued to use the spray alone for seven
more months.

After six months, just after the patch was removed, nearly twice as
many of the smokers on the combination therapy -- 31 percent -- were
still abstaining, compared to 16 percent on the patch alone.

At one year, the difference was almost triple, with 27 percent of
those using the combination method still not smoking, compared with 11
percent of those who had used only the patch.

At six years, 16 percent in the combination group remained
non-smokers, while 8.5 percent in the patch group were abstaining.

To qualify as a success, the smokers were not allowed to have a single
puff.

Dr. Thorsteinn Blondal, who led the study, said most of the smokers
who failed relapsed in the second year, just after the nasal spray was
taken away from them.

He said he believed the combination helped smokers quit because it
teamed the patch's slow release of nicotine with the rapid infusion
emitted by the spray whenever the smoker responded to a craving.

Dr. Richard Hurt, director of the Nicotine Dependence Center at the
Mayo Clinic in Rochester, Minn., called the findings ``very
encouraging.''

``It says it's not only OK to use a patch and nasal spray in
combination, but that it probably enhances their chances of
stopping,'' Hurt said.

Scientists have been studying the effectiveness of
nicotine-replacement therapies for years, but studies have rarely
stretched beyond a year.