Previous research on combination NRT paired the patch with either nicotine gum 25, 32, nicotine nasal spray 7, 33 or nicotine inhaler 34, 35. The present results suggest that the nicotine lozenge can also be effective as an adjuvant to the nicotine patch. The key seems to be that an ad libitum, or “as needed”, agent must be paired with the patch; simply using higher patch doses does not seem to augment outcomes to the same degree.36–39 While the nicotine lozenge appears to be an effective patch adjuvant, its performance as a monotherapy was not as impressive as the patch. For instance, the lozenge did not produce significantly higher cessation rates than placebo in either the first week of treatment or at EOT (with alpha adjustment; see Table 3).
