A new analysis conducted between Italy and USA has evaluated the effectiveness of the currently available methods to quit smoking, concluding that these products, which include both pharmaceutical cessation products and nicotine substitution products, offer more tailored solutions for individual sensory and nicotine delivery preferences and can improve efficacy of smoking cessation paths.
Catania, 23 October 2024– Analyzing and understanding the mechanisms that affect the efficacy of cessation treatments translates into a higher chance of quitting smoking for good. Despite the FDA having approved the first cessation drugs nearly forty years ago, smoking remains one of the leading causes of death worldwide, even though it is well established that abstention from smoking for as little as 3 years can reduce excess mortality risk by over 50%. Yet, the effectiveness of smoking cessation products remains low, with an average of 30 attempts needed for each successful cessation outcome.
Real-world efficacy of stop-smoking products is often limited by inadequate dosing and poor adherence.
In the recent study “Personalized and Adaptive Interventions for Smoking Cessation: Emerging Trends and Determinants of Efficacy”, an international research team, led by Dr. Gal Cohen, Head of Scientific Affairs at Rose Research Center, and conducted in collaboration with Italian researchers from CoEHAR, the research center of the University of Catania founded by Prof. Riccardo Polosa, analyzed the limitations and prospects of the most commonly used smoking cessation methods, concluding that adaptive smoking cessation approaches can represent a better solution for individuals who struggle with traditional methods.
This state-of-the-art review article in iScience highlights the complexities of cigarette addiction and innovations in cessation products. By focusing on individual determinants of efficacy—such as sensory preferences and nicotine tolerability—the article offers fresh insights into smoking cessation and advocates for personalized, adaptive treatment plans. It also highlights how emerging approaches, like cytisine and combustion-free nicotine delivery systems, provide promising new avenues to reduce smoking-related morbidity.
“Quitting smoking is hard; you are trying to extinguish the complex interplay of nicotine delivery, sensorial experience and use ritual that cigarettes provide to people who smoke” explains Dr. Cohen. “However, the emerging array of pharmaceutical cessation therapies and nicotine substitution products offer the opportunity to personalize the off-ramp from smoking.”
While current smoking cessation medications show promise in clinical trials, quit rates remain low and in real-world use dosing and adherence are typically inadequate. Various combinations of products can be explored to create adaptive protocols that also take into account populations more likely to respond positively to nicotine replacement therapies.
New products, which include both pharmaceutical cessation products such as cytisine formulations and nicotine vaporizers, and nicotine substitution products such as e-cigarettes, heated tobacco products, and oral nicotine products, offer more tailored solutions for individual sensory and nicotine delivery preferences.
Data corroborated in the US, where the most used products to stop smoking are nicotine delivery products, which include medicinal nicotine replacement therapies (NRTs) and consumer nicotine substitution products. NRTs include medicinal nicotine patches, gums, lozenges, inhalers, and nasal sprays.
“However- states prof. Polosa- these NRTs provide neither the bolus nicotine delivery nor the sensory stimuli and behavioral rituals associated with smoking. Conversely, ENDS represent the most prevalent nicotine substitution products and were used every day or some days by 11-17 million U.S. adults”.
In a survey of adults who vape in the US, UK, and Canada, 73% reported wanting to quit smoking as a reason for use. “A fact also confirmed by the scientific community,” adds the Catanese scientist, “where the evidence on the effectiveness of electronic cigarettes and similar products has reached a point that can no longer be ignored”.
Like any significant modification of a habituated behavior, whether involving consumption of food, exercise, or other chronic habits, supportive care is a validated and efficacious component. In conclusion, innovative evidence-based adaptive protocols may help personalize therapies to boost the success of quitting and to prevent high relapse rates.
