During treatment, the patch, bupropion + lozenge, and patch + lozenge conditions were all significantly more efficacious than placebo, with the familywise error correction. However, after treatment was discontinued, by 6 months post-quit, only the patch + lozenge remained efficacious. These findings agree with the 2008 Guideline Update meta-analyses that showed that the combination of long-term patch + gum or spray had the highest odds ratio for efficacy (6-month abstinence) of any of the evaluated pharmacotherapies (monotherapies and combination therapies) when tested against a placebo control condition (OR = 3.6).1 These findings suggest that long-term pharmacotherapy (> 14 weeks), particularly with the nicotine patch, may be important given that the effects of bupropion + lozenge diminished significantly once participants stopped using them at the end of treatment. Future research should examine relapse dynamics following the discontinuation of treatment; it would be important to know if treatment discontinuation was more consequential for some pharmacotherapies than for others (e.g., 27, 28). Future research should also address the promising issue of using pharmacotherapy prior to the quit attempt.1, 2
