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Physician Advice Askabout smoking Advisequit attempt Assesswillingness to quit Assistwith treatment Arrangefollow-up Pharmacologic Treatments Nicotine Gum Nicotine Patch Nicotine Spray Nicotine Inhaler Nicotine Lozenge Zyban (bupropion) Others Pharmacologic Treatments Nicotine Gum Some adverse side-effects such as oral and gastric problems, jaw ache, under-dosing 2mg dose outperforms placebo at 6-month assessment (OR=1.66) 4mg dose more effective than 2mg, particularly among more dependent smokers tends not to be effective with brief advice Pharmacologic Treatments Transdermal Nicotine Patch Relatively few side effects, popular form of NRT 21mg/4 weeks, 14mg/2weeks, 7mg/2weeks Shown to double quit rates achieved by placebo at EOT Combined with physician advice, quit rates can reach 28% at 12-month follow-up 1 No conclusive evidence to show that the higher, 42 - 44 mg initial dose, produces higher quit rates than 21 - 22 mg dose 2 1 Hurt et al., JAMA, 1994

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