Brown professor the lead consultant on new product to speed relief to smokers craving nicotine

Raymond Niaura recently showed that an experimental gum might provide smokers with faster and better relief from cravings compared to Nicorette.

by Scott J. Turner

Up to 90 percent of smokers who try to quit relapse within the first year. Most smoking-cessation experts say that rapid relief of cravings is key to successfully kicking the habit.

One of those experts, Raymond Niaura, recently showed that an experimental gum might provide smokers with faster and better relief from cravings compared to Nicorette, the popular over-the-counter product. The professor of psychiatry and human behavior presented his findings Feb. 21 at the annual meeting of the Society for Research on Nicotine and Tobacco.

The new gum relies on a novel gum base and buffer system, as well as on a distinctive mechanism to bond the nicotine before it is released in the mouth, Niaura said. The gum discharges nicotine more rapidly in the first few minutes compared to other nicotine gums, and continues to deliver a controlled, gradually reduced dose while it is chewed, he said.

“By relieving cravings quickly, rapid-release nicotine gum should decrease the chances of relapse and increase the chances of successful quitting,” said Niaura, who helped design and conduct the study. “In the real world, people who quit smoking often find themselves in situations where they experience strong cravings. The sooner a person relieves cravings, the less the chance that they’ll smoke in that situation.”

The study was designed to reflect real-world experiences of people quitting smoking. In it, 319 smokers reported on the strength of their cravings before and after being exposed to a cigarette of their preferred brand, which they handled and lit without inhaling. Each smoker then chewed a piece of rapid-release gum or Nicorette for 30 minutes.

After three minutes, smokers chewing the rapid-release gum reported significantly lower cravings than those chewing Nicorette. By the end of 30 minutes, 92 percent of rapid-release gum chewers had achieved meaningful relief versus 77 percent of those using Nicorette. Three times as many participants on rapid-release gum reported achieving complete relief from cravings than did users of Nicorette.

The gum is still in an experimental stage. Developed by two companies, JSR, LLC, and Biovail Corporation, the gum has not been evaluated or approved by the U.S. Food and Drug Administration for marketing to smokers. Two U.S. patents have been issued covering the technology, and the companies are working toward commercializing the product. Bayer Consumer Care funded the study.

Niaura directs research at the Centers for Behavioral and Preventive Medicine, Brown Medical School/The Miriam Hospital. He and colleagues have conducted numerous studies on nicotine cravings. Niaura has no current affiliation with Bayer Consumer Care.

Some addiction specialists think that nicotine delivered through cigarettes is as addictive as heroin, cocaine and alcohol. Smokers experience cravings for nicotine, and other physical withdrawal symptoms, when their blood levels of the drug get too low. Replacing nicotine from cigarettes with nicotine in a therapy, such as gum, helps relieve cravings experienced by smokers trying to quit.

Smoking delivers nicotine to the bloodstream within a few seconds. Nicotine replacements usually work more slowly, and the amount of nicotine in the bloodstream is lower compared to smoking. According to the American Cancer Society, nicotine replacement is a cleaner form of nicotine, avoiding the thousands of poisons and tar found in burning tobacco. In addition, nicotine replacement reduces withdrawal symptoms, allowing a smoker to focus on the psychological aspects of quitting.

Addiction specialists say nicotine replacement therapy should be combined with other methods, such as a stop-smoking program, that addresses the habit’s psychological component.