Treating smokers before the quit date: Can nicotine patches and denicotinized cigarettes reduce cravings?

November 1, 2007

Roswell Park Cancer Institute

Rezaishiraz et al. – November 2007, Nicotine & Tobacco Research. 9:1139-1146

Key Takeaways

  • Use of VLNC cigarettes before use of nicotine patches increased quit rates over similar use of reduced nicotine cigarettes (containing 10 times more nicotine than the VLNC cigarettes) before nicotine patches
  • The use of VLNC cigarettes combined with the nicotine patch appears to lessen cravings to smoke in the immediate post cessation period
  • Funded by institutional resources from Roswell Park Cancer Institute


  The present study investigated whether treatment with the combination of denicotinized cigarettes and 21-mg nicotine patch for 2 weeks before a designated quit date could lessen cravings for smoking, thereby helping smokers abstain from smoking. The study was a randomized controlled clinical trial conducted at Roswell Park Cancer Institute, Buffalo, New York, in 2004 and 2005. Patients included 98 adult heavy smokers (using 20 or more cigarettes/day). Half of the subjects received 2 weeks of combination of denicotinized cigarettes (Quest 3) and 21-mg nicotine patch for 2 weeks before the quit date. The remaining smokers were switched to light cigarettes (Quest 1) during the 2 weeks before the quit date. After the quit date, all subjects received counseling for smoking cessation and were provided nicotine patches for up to 8 weeks after the quit date. Self-reported cravings for smoking, withdrawal symptoms, and smoking abstinence were measured at predetermined intervals using phone-based surveys and in clinical visits. The group that used denicotinized cigarettes and nicotine patch before quitting reported less frequent and less intense cravings for cigarettes in the 2 weeks before and after the designated quit date. Self-reported withdrawal symptoms and quit rates did not differ significantly between the groups. The use of a denicotinized cigarette combined with the nicotine patch appears to lessen cravings to smoke in the immediate postcessation period. A larger, better-powered study is needed to test if this treatment combination has merit for increasing quit rates.