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# Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up #article-title-2 Objective: To evaluate the efficacy of using a nicotine patch for 5 months with a nicotine nasal spray for 1 year. Design: Placebo controlled, double blind trial. Setting: Reykjavik health centre. Subjects: 237 smokers aged 22-66 years living in or around Reykjavik. Interventions: Nicotine patch for 5 months with nicotine nasal spray for 1 year (n=118) or nicotine patch with placebo spray (n=119). Treatment with patches included 15 mg of nicotine for 3 months, 10 mg for the fourth month, and 5 mg for the fifth month, whereas nicotine in the nasal spray was available for up to 1 year. Both groups received supportive treatment. Main outcome measure: Sustained abstinence from smoking. Results: The log rank test for 6 years (χ2=8. 5, P=0. 004) shows a significant association between abstinence from smoking and type of treatment. Sustained abstinence rates for the patch and nasal spray group and patch only group were 51% v 35% after 6 weeks (P=0. 011 (χ 2), 95% confidence interval 1. 17% to 3. 32%), 37% v 25% after 3 months (P=0. 045, 1. 01% to 3. 08%), 31% v 16% after 6 months (P=0. 005, 1. 27% to 4. 50%), 27% v 11% after 12 months (P=0. 001, 1. 50% to 6. 14%), and 16% v 9% after 6 years (P=0. 077, 0. 93% to 4. 72%). Conclusions: Short and long term abstinence rates show that the combination of using a nicotine patch for 5 months with a nicotine nasal spray for 1 year is a more effective method of stopping smoking than using a patch only. The low percentage of participants using the nasal spray at 1 year, and the few relapses during the second year, suggest that it is not cost effective to use a nasal spray for longer than 7 months after stopping a patch. # Commentary: Progress on nicotine replacement therapy for smokers #article-title-20
Blöndal et al. (Sat,) studied this question.