This protocol evaluates the efficacy of combining pharmacologic treatments for smoking
cessation, entailing the use of the nicotine skin patch with the nicotinic antagonist
mecamylamine, with a specific behavioral therapy designed to inhibit the smoking urge.
Previous studies have found that nicotine/mecamylamine treatment more than doubles the
long-term abstinence rates relative to nicotine replacement alone. Recent evidence supports
the hypothesis that nicotine/mecamylamine treatment prior to smoking cessation partially
blocks the rewarding effects of cigarette smoking and hence promotes extinction of the
smoking habit, facilitating subsequent abstinence. The behavioral approach employed is also
an extinction strategy and involves having smokers switch to de-nicotinized tobacco
cigarettes for two weeks prior to quitting smoking. It is hypothesized that the use of
de-nicotinized cigarettes might provide more complete extinction than provided by the
partial pharmacologic blockade using nicotine/mecamylamine alone. The pharmacologic
treatment was expected to increase compliance with the de-nicotinized cigarette smoking
regimen, because subjects' usual brands of cigarettes will be less appealing than in the
absence of nicotine/mecamylamine treatment. Together the brand-switching and
nicotine/mecamylamine therapies were expected to reduce cravings and other withdrawal
symptoms as well as increase long-term abstinence from smoking.
- Ages 18-65, wanted to quit smoking.
- Must be in good health
- Exclude cardiac disease, hypotensive or hypertensive, skin allergy, glaucoma,
prostatic hypertrophy, pregnant women, drug or alcohol abuse, kidney disease.