Triple-Combination Pharmacotherapy for Medically Ill Smokers

A Randomized Trial

This article examines the effectiveness of a triple-combination pharmacotherapy for smokers who are medically ill. Medically ill smokers make up a disproportionately high percentage of all smokers, and there has been limited research on effective smoking cessation treatments for this population.

The authors conducted a randomized clinical trial between 2005 and 2007 with 127 subjects. Subjects received either the nicotine patch alone or the triple-combination of nicotine patch, nicotine oral inhaler, and bupropion ad libitum.

Key Findings:

  • After six months, 35 percent of subjects who received the triple-combination therapy had stopped smoking, compared to 19 percent of the subjects who received the nicotine patch alone.
  • The average time to relapse was significantly longer for patients receiving the triple combination therapy (65 days) than the nicotine patch alone (23 days).
  • While side effects such as insomnia and anxiety were higher among the triple-combination subjects, the proportion of subjects who discontinued therapy because of adverse side effects was the same between the triple-combination and control groups.

Triple-combination therapy appears to be more successful at helping ill smokers to stop smoking than the nicotine patch alone.