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Smoking Topography Predicts Abstinence following Treatment with Nicotine Replacement Therapy

¹ Transdisciplinary Tobacco Use Research Center, Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania and ² Intramural Research Program, Clinical Pharmacology Branch, National Institute on Drug Abuse, Baltimore, Maryland

Requests for reprints: Andrew A. Strasser, Transdisciplinary Tobacco Use Research Center, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104-3309. Phone: 215-746-5788; Fax: 215-746-7140. E-mail: strasse3{at}mail.med.upenn.edu

Objective: Smoking topography refers to how a person smokes a cigarette and includes measures of the number of puffs and puff volume, duration, and velocity. This study examined the relationship between smoking topography and abstinence from cigarettes following nicotine replacement therapy. A secondary objective was to determine the relationship of smoking topography to carbon monoxide (CO) exposure.

Method: Participants (n = 113) smoked one of their preferred brands of cigarette through a smoking topography device prior to participating in an open-label trial of transdermal nicotine versus nicotine nasal spray. A subset of participants (n = 50) provided breath CO samples prior to and following smoking the cigarette.

Results: Mean V_max [odds ratio (OR), 1.12; 95% confidence interval (95% CI), 1.02-1.24; P = 0.02], mean puff volume (OR, 0.95; 95% CI, 0.91-0.98; P = 0.01), mean interpuff interval (OR, 1.06; 95% CI, 1.00-1.11; P = 0.03), and cigarette type (full flavor versus light/ultralight; OR, 0.35; 95% CI, 0.14-0.89; P = 0.03) were significant predictors of abstinence in a model controlling for treatment group and nicotine dependence. Controlling for time since last cigarette and initial CO level, mean puff velocity (ß = 0.171; P = 0.01) was the only significant predictor of CO boost.

Conclusion: These results suggest that smoking topography may be useful to predict abstinence after using nicotine replacement therapy and to assess harm from smoking.

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