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ARTICLE |

A Trial of Clonidine to Stop Smoking FREE

Linda M. Lucas, MD
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Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.


JAMA. 1990;263(20):2746-2746. doi:10.1001/jama.1990.03440200048010
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To the Editor.—  Highly dependent smokers, as defined by Fagerstrom tolerance scores of 7 and above, often have more severe withdrawal syndromes and lower quit rates than mildly or intermediately dependent smokers.1,2 It is recommended that these highly dependent smokers receive more intensive support in the form of behavioral modification classes and counseling.2 Also, use of nicotine gum raises long-term verified quit rates in this group.3 However, nicotine gum does not appear to be effective (and is not recommended by the manufacturer) without the patient's active participation in a behavioral modification program.4 Even with these treatment regimens, long-term verified quit rates in highly dependent smokers are low, ranging from 6% to 44%.3As Franks et al5 point out in their article entitled "Randomized, Controlled Trial of Clonidine for Smoking Cessation in a Primary Care Setting," clonidine hydrochloride therapy by itself without an intensive

REFERENCES

Fagerstrom KO.  Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment . Addict Behav. 1978;:3:235-241.
Clinical Opportunities for Smoking Intervention: A Guide for the Busy Physician . Bethesda, Md: National Heart, Lung, and Blood Institute; 1986;. National Institutes of Health publication 86-2178.
Tonnesen P, Vibeke F, Hansen M, et al.  Effect of nicotine chewing gum in combination with group counseling on the cessation of smoking . NEngl JMed. 1988;;318:15-18.
Lucas LM, Baker LH, Wall MA.  Physicians can help patients quit smoking . Med Rounds . 1988;;26:266-272.
Franks F, Harp J, Bell B.  Randomized, controlled trial of clonidine for smoking cessation in a primary care setting . JAMA . 1989;;262:3011-3013.

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Fagerstrom KO.  Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment . Addict Behav. 1978;:3:235-241.
Clinical Opportunities for Smoking Intervention: A Guide for the Busy Physician . Bethesda, Md: National Heart, Lung, and Blood Institute; 1986;. National Institutes of Health publication 86-2178.
Tonnesen P, Vibeke F, Hansen M, et al.  Effect of nicotine chewing gum in combination with group counseling on the cessation of smoking . NEngl JMed. 1988;;318:15-18.
Lucas LM, Baker LH, Wall MA.  Physicians can help patients quit smoking . Med Rounds . 1988;;26:266-272.
Franks F, Harp J, Bell B.  Randomized, controlled trial of clonidine for smoking cessation in a primary care setting . JAMA . 1989;;262:3011-3013.
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To understand the clinical management of acute heart failure syndromes.
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