Original Article
The Safety of Transdermal Nicotine as an Aid to Smoking Cessation in Patients with Cardiac Disease
N Engl J Med 1996; 335:1792-1798December 12, 1996
- Abstract
Background
Transdermal nicotine therapy is widely used to aid smoking cessation, but there is uncertainty about its safety in patients with cardiac disease.
Methods
In a randomized, double-blind, placebo-controlled trial at 10 Veterans Affairs medical centers, we randomly assigned 584 outpatients (of whom 576 were men) with at least one diagnosis of cardiovascular disease to a 10-week course of transdermal nicotine or placebo as an aid to smoking cessation. The subjects were monitored for a total of 14 weeks for the primary end points of the study (death, myocardial infarction, cardiac arrest, and admission to the hospital due to increased severity of angina, arrhythmia, or congestive heart failure); the secondary end points (admission to the hospital for other reasons and outpatient visits necessitated by increased severity of heart disease); any side effects of therapy; and abstinence from smoking.
Results
There were 48 primary and 78 secondary end points noted in a total of 95 subjects. At least one of the primary end points was reached by 5.4 percent of the subjects in the nicotine group and 7.9 percent of the subjects in the placebo group (difference, 2.5 percent; 95 percent confidence interval, -1.6 to 6.5 percent; P = 0.23). In the nicotine group, 11.9 percent of the subjects had at least one of the secondary end points, as compared with 9.7 percent in the placebo group (difference, 2.2 percent; 95 percent confidence interval, -2.2 to 7.4 percent; P = 0.37). After 14 weeks the rate of abstinence from smoking was 21 percent in the nicotine group, as compared with 9 percent in the placebo group (P = 0.001), but after 24 weeks the abstinence rates were not significantly different (14 percent vs. 11 percent, P = 0.67).
Conclusions
Transdermal nicotine does not cause a significant increase in cardiovascular events in high-risk outpatients with cardiac disease. However, the efficacy of transdermal nicotine as an aid to smoking cessation in such patients is limited and may not be sustained over time.
Media in This Article
Table 1
Base-Line Characteristics of the Study Groups.Table 2
Serious Adverse Events According to Study Group.Article Activity
- Article
Cigarette smoking promotes atherosclerosis and is associated with an increased risk of sudden death, myocardial infarction, angina, peripheral vascular disease, and stroke.1 In patients with cardiac disease who stop smoking, there is a rapid decline in the recurrence of acute cardiovascular events and the symptoms of atherosclerotic disease.2 Transdermal nicotine has been shown to be of benefit as an aid to smoking cessation3 and is a prominent feature of the Clinical Practice Guideline for smoking cessation of the Agency for Health Care Policy and Research.4 There is ongoing debate, however, about the safety of transdermal nicotine in patients with cardiac disease.5
The use of transdermal nicotine in patients with atherosclerotic vascular disease is of concern because some of the cardiotoxic effects of smoking are attributable to nicotine (although some are caused by other components of cigarette smoke). Nicotine has sympathomimetic effects that lead to increases in heart rate and blood pressure6 and cause coronary vasoconstriction.7 Components of cigarette smoke other than nicotine contribute to cardiovascular injury by causing the production of carboxyhemoglobin (consequently reducing the delivery of oxygen),8 increasing platelet aggregation and serum fibrinogen levels,9 adversely affecting the lipid profile,10 and promoting oxidant injury11 and the activation of neutrophils.12 Treatment with transdermal nicotine, however, generally leads to lower blood nicotine levels than does cigarette smoking,9 even if the patient continues to smoke during treatment.13,14 Pharmacologic therapy with nicotine is therefore likely to result in fewer cardiovascular effects than cigarette smoking.
Anecdotal reports of paroxysmal atrial fibrillation,15-17 myocardial infarction,18-22 and stroke23,24 in patients receiving nicotine therapy have made physicians cautious in prescribing nicotine gum or transdermal patches for patients with cardiac disease.25 Some physicians consider underlying cardiac conditions in patients who smoke as absolute contraindications to nicotine therapy, although others prescribe reduced doses. Reports in the press of adverse events have made some patients leery of nicotine therapy and may have deterred attempts to quit smoking.21 The Food and Drug Administration has recently approved transdermal nicotine for sale over the counter, which makes it imperative to determine the drug's safety in patients with cardiovascular disease. Our study was a randomized, double-blind, placebo-controlled, multicenter trial designed to evaluate the safety and efficacy of transdermal nicotine as an aid to smoking cessation in cigarette smokers with at least one major cardiovascular disorder.
Methods
Participants
Inclusion Criteria
In 10 Veterans Affairs medical centers (VAMCs), we enrolled smokers, 45 years of age or older, who smoked at least 15 cigarettes per day. The subjects must have smoked for at least five years, made a minimum of two previous attempts to quit, and had a level of carbon monoxide in expired air of more than 8 parts per million (ppm). All subjects had one or more of the following diagnosed conditions: a history of myocardial infarction, a history of coronary-artery bypass surgery or angioplasty, stenosis of at least 50 percent in at least one major coronary artery as seen with coronary angiography, or a clinical history of angina, congestive heart failure, cor pulmonale, arrhythmia, peripheral vascular disease, or cerebrovascular disease.
Exclusion Criteria
Criteria for exclusion were any of the following in the two weeks before randomization: unstable angina, myocardial infarction, coronary-artery bypass surgery, angioplasty, or hospitalization for cardiac arrhythmia. A history of continuous use of transdermal nicotine for more than 48 hours, current use of (and an unwillingness to stop using) other tobacco products or nicotine gum, the presence of unstable psychiatric illness or an unstable disorder involving the use of alcohol or controlled substances, a history of severe dermatitis, and pregnancy were additional exclusion criteria.
Randomization and Treatment
The Minneapolis VAMC Coordinating Center used a computer-generated schedule to randomly assign patients to the study groups in blocks of 10. The protocol was approved by the institutional review boards at all 10 sites. Potential subjects were advised that they would be told to quit smoking one day after randomization.
Pharmacologic Treatment
The treatment protocol prescribed transdermal nicotine (Nicoderm, Hoechst Marion Roussel) given as a 21-mg patch for 6 weeks, a 14-mg patch for 2 weeks, and a 7-mg patch for 2 weeks, for a total course of treatment of 10 weeks. Subjects in the placebo group were given placebo patches of identical size, appearance, and odor. All subjects were instructed to apply a new patch each morning after removing the old patch, and to place the patch in a different position each day to avoid skin irritation.
Other Treatment
Subjects returned to the hospital for outpatient visits at the end of the 1st, 6th, and 14th weeks. They received the National Cancer Institute's pamphlets “Clearing the Air”26 and “Why Do You Smoke?”27 at the base-line visit. Subjects were instructed not to smoke while wearing patches. They received brief behavioral counseling, by either the principal investigator or the study coordinator, which lasted for 15 minutes at the base-line visit and for 10 minutes at each of the next two visits (week 1 and week 6).
Deviations from the Protocol
If at the week 6 visit subjects reported having smoked more than five cigarettes in the previous week or had a carbon monoxide level in expired air of more than 8 ppm, the patch treatment was discontinued. Subjects with symptoms of nicotine toxicity (including diarrhea, abdominal pain, vomiting, dizziness, and headache) that were rated as severe had their dose decreased from 21 mg to 14 mg. These subjects received an accelerated and shortened course of treatment after the first reduced dose: 14 mg for two weeks and 7 mg for two weeks. If their only severe symptom was sleep disturbance, subjects were instructed to remove the 21-mg patch at night, but otherwise they kept receiving treatment according to the protocol.
Data Collection
Information on the subjects' employment status, education, smoking behavior (the nicotine content of their usual brands of cigarettes as calculated with the Federal Trade Commission's smoking-machine method28 and the responses to the Fagerström Tolerance Questionnaire29), and medical history, as well as the smoking status of household members, was collected at the base-line visit. The subjects kept weekly diaries of their patch use, the number of cigarettes smoked, any symptoms of nicotine withdrawal or toxicity, and the number of visits made to health care providers. At each scheduled study visit the subjects returned the diaries as well as all used and unused patches, which were counted. At all 10 sites the level of expired carbon monoxide was measured with Bedfont Micro Smokerlyzers (Bedfont Scientific). The subjects were instructed to hold their breath for 15 seconds before exhaling into the meter.
Outcome Measures
Safety
The subjects reported adverse events in their weekly diaries and at scheduled study visits, and study personnel also reviewed the hospitals' computerized patient records to ascertain and verify end points (e.g., hospitalization).
Adverse events were classified as mild, moderate, or serious. Serious adverse events were further classified a priori into three groups of end points. Primary end points were death, myocardial infarction, cardiac arrest, and admission to the hospital due to increased severity of angina, arrhythmia, or congestive heart failure. Secondary end points were admission due to peripheral vascular disease, cerebrovascular disease, or other indications and outpatient visits necessitated by the increased severity of atherosclerotic cardiac diseases (angina, arrhythmia, or congestive heart failure). The third category of end points consisted of potential side effects of therapy with transdermal nicotine, such as sleep disturbance, a skin reaction, gastrointestinal distress, and miscellaneous other symptoms that were rated as severe and required adjustment of the patient's dose. Predetermined criteria were used to evaluate the relation of administration of the drug to an adverse event; either the drug and the event were considered not related or the relation was classified as remote, possible, probable, or definite.
Efficacy
Abstinence was defined as the subject's not having smoked for at least 8 weeks, as verified at the end of the 14th week after randomization by a level of expired carbon monoxide of 10 ppm or less. At 24 weeks, subjects who reported by telephone that they had not smoked, and who underwent a confirmatory measurement of their level of expired carbon monoxide, were considered abstinent.
Statistical Analysis
Sample size was calculated on the basis of a rate of approximately 15 percent for the combined end points in the control group, the rate observed in a pilot study.14 We therefore planned to enroll approximately 580 subjects in order to have a power of 0.9 (alpha, 0.05; one-sided analysis) to detect an increase of 10 percentage points in the rate of adverse events due to treatment. The nicotine and placebo groups were compared with respect to a large number of base-line variables involving the subjects' medical history, severity of cardiac disease, history of smoking, and the results of physical examination. Analysis of variance was used for continuous variables, and chi-square analysis was used for categorical variables. Analyses were conducted both according to subject and according to event, because some subjects had more than one event and the events were not independent. The most serious adverse event for each subject who had more than one event was used for analysis. We cross-classified serious events according to the original group assignment (intention to treat), among subjects who wore nicotine patches according to the protocol, and according to smoking status. All data analyses were performed with SAS software.30
Results
Characteristics of the Study Subjects
We enrolled 584 subjects in the trial, 8 of whom were women, between November 28, 1994, and June 30, 1995. The subjects were on average 60 years of age (range, 45 to 82). From 24 to 116 subjects were enrolled at each site.
Medical History and Physical Examination
The most common reasons for inclusion in the study were a history of myocardial infarction (40 percent of the subjects), a history of coronary-artery bypass surgery or angioplasty (35 percent), a clinical history of angina (36 percent), and the presence of peripheral vascular disease (34 percent). Other medical conditions common among the subjects were hypertension (35 percent), chronic obstructive pulmonary disease (21 percent), diabetes (17 percent), depression (11 percent), peptic ulcer disease (10 percent), other psychiatric conditions (9 percent), and a history of a substance-use disorder (6 percent).
Commonly used medications included anticoagulants (used by 11 percent of the subjects), opioid analgesics (14 percent), antidepressants (15 percent), digitalis (14 percent), beta-blockers (23 percent), calcium-channel blockers (29 percent), nitrates (45 percent), antiarrhythmic agents (2 percent), lipid-lowering agents (13 percent), diuretics (19 percent), angiotensin-converting–enzyme inhibitors (24 percent), histamine antagonists (24 percent), hypoglycemic agents (12 percent), and therapeutic drugs for chronic obstructive pulmonary disease (18 percent). There were no significant differences in medication use between the nicotine group and the placebo group.
Patients in both study groups who reported angina at base line had an average of two episodes per week and took an average of almost two sublingual nitroglycerin tablets per week. The majority of subjects were in Canadian Cardiovascular Society (CCS) class I (that is, they reported having angina only with strenuous work). Measurements of weight, blood pressure, and pulse were similar in the two groups (Table 1Table 1
Base-Line Characteristics of the Study Groups.).Smoking History
On average, subjects reported smoking 28 cigarettes per day at base line and had smoked for 44 years. For 86 percent of the subjects, the delivered nicotine content of their usual brand of cigarettes was less than 1.2 mg. The average score on the Fagerström Tolerance Questionnaire was 6.4 and the base-line level of expired carbon monoxide was 25 ppm in both the nicotine and placebo groups (Table 1).
Outcome Measures
There were 48 primary and 78 secondary end points observed in a total of 95 of the study subjects. In the nicotine group, 5.4 percent (16 subjects) had primary end points, as compared with 7.9 percent of the placebo group (23 subjects) (difference, 2.5 percent; 95 percent confidence interval, -1.6 to 6.5 percent; P = 0.23) (Table 2Table 2
Serious Adverse Events According to Study Group.). The distribution of primary end points was similar in the two groups, with the exception of deaths, which were more common in the placebo group. However, that difference did not reach statistical significance (P = 0.07).There were no significant differences between groups in the occurrence of secondary end points (nicotine group, 11.9 percent; placebo group, 9.7 percent; difference, 2.2 percent; 95 percent confidence interval, -2.2 to 7.4 percent; P = 0.37). More subjects in the nicotine group (12) than in the placebo group (7) had outpatient visits for chest pain, arrhythmia, or congestive heart failure (P = 0.5). In both study groups, 16 percent of the subjects had either a primary or a secondary end point (nicotine group, 16.3 percent; placebo group, 16.2 percent; difference, 0.1 percent; 95 percent confidence interval, -5.9 to 6.1 percent; P = 0.97) (Table 2).
Use of Patches at the Time of Events
Because some subjects discontinued therapy on their own, we also analyzed the data considering only subjects who used patches according to the study protocol. At the week 6 visit, 73 percent of the subjects in the nicotine group were wearing patches, as compared with 56 percent in the placebo group (P = 0.004). In this analysis, 15.3 percent of the nicotine group (29 subjects) had primary or secondary end points, as compared with 11.6 percent of the placebo group (20 subjects) (P = 0.48). There were 39 primary and secondary end points in the nicotine group, as compared with 27 end points in the placebo group (P = 0.86).
Smoking Status at the Time of Events
Smoking status at the time of an end point was reported for 86 of the 95 subjects who had primary or secondary end points. At the time of 45 primary and secondary events in the nicotine group, 19 subjects (42 percent) were abstaining from smoking and 26 (58 percent) were smoking; at the time of 41 events in the placebo group, 9 subjects (22 percent) were abstaining from smoking and 32 (78 percent) were still smoking (P = 0.05) (Table 3Table 3
Subjects' Smoking Status at the Time of Serious Adverse Events, According to Study Group.). We also compared the occurrence of end points in 294 subjects in the nicotine group according to their smoking status at 14 weeks. Nine percent of the abstinent subjects had primary end points, as compared with 5 percent of those who were still smoking, and 13 percent had secondary end points, as compared with 10 percent of subjects still smoking (P = 0.29 for a combined primary and secondary end point).Side Effects of Transdermal Nicotine
The distribution of side effects commonly attributed to nicotine patches, such as sleep disturbance, skin reactions, and gastrointestinal distress, was similar in the two study groups (Table 4Table 4
Severe Side Effects of Transdermal Nicotine Therapy, According to Study Group.).The principal investigator at each site assessed the relation of administration of the study drug to study end points and potential side effects of therapy with transdermal nicotine; the drug was considered to be not related or only remotely related to the event in 64 percent of adverse events (92 of 143), possibly related in 20 percent of events (29), probably related in 9 percent of events (13), and definitely related in 6 percent of events (9). There were no significant differences in these rates between the nicotine group and the placebo group. There were also no differences according to study group in the rates of dose adjustment, discontinuation of medication, or the addition of medication necessitated by an adverse event.
Physical Examination
Subjects in the nicotine group gained an average of 1.4 kg between base line and the 14th week, as compared with 0.3 kg in subjects receiving placebo (P = 0.001). Changes in systolic and diastolic blood pressure and pulse were negligible in both study groups.
Efficacy
At 14 weeks after randomization, 21 percent of the subjects in the nicotine group and 9 percent in the placebo group were abstaining from smoking, as confirmed by the measurement of expired carbon monoxide (P = 0.001). However, at 24 weeks, 14 percent of the subjects in the nicotine group, as compared with 11 percent in the placebo group, were abstaining (P = 0.67).
Discussion
This multicenter study showed that serious adverse events are common and occur at nearly the same rate among subjects with cardiovascular disease who try to quit smoking, regardless of whether they use transdermal nicotine or placebo. In our study, the proportion of primary end points was greater in the placebo group, but the proportion of secondary end points was greater in the nicotine group. Neither of these differences, however, was statistically significant. There was no increase in death, myocardial infarction, or arrhythmia associated with transdermal nicotine, regardless of whether the data were analyzed according to the intention to treat or according to the actual use of patches. Symptoms commonly attributed to treatment with nicotine patches, such as sleep disturbance, skin reactions, and gastrointestinal distress, were equally common in both study groups.
These findings are consistent with a previous study assessing therapy with transdermal nicotine in patients with cardiac disease.5 Those investigators conducted a five-week, placebo-controlled trial, with a lower dose of transdermal nicotine (14 mg) than the one we used, in 156 patients with documented atherosclerotic cardiovascular disease. One subgroup of patients underwent extensive monitoring, including 24-hour electrocardiography. There was no difference between the treatment and placebo groups in the frequency of angina.5 In our study, intervention was less efficacious than it was in trials of intervention to stop smoking among inpatients with acute cardiac disease; in those trials, success rates were unusually high, even without the use of pharmacologic therapy.31-34 A high prevalence of coexisting psychiatric conditions in the population we were studying and a history of numerous past failures to quit smoking may explain this finding.
The finding of multiple adverse events in the control group in our study brings a new perspective to published case reports of cardiac events among patients receiving nicotine-replacement therapy.15-25 These previous reports have stressed the importance of concurrent patch use and smoking. Our data, however, show that more adverse events occurred in subjects wearing placebo patches who smoked during treatment than in subjects wearing active patches who smoked, and they show no increase in events among smokers as compared with nonsmokers (although the subjects in this analysis were not randomly assigned). Several factors are important in evaluating the risk of using patches without abstaining from smoking: the effect of nicotine treatment, the effect of nicotine withdrawal, and the number of cigarettes subjects continue to smoke. Having smoked in the three days before an adverse event may result in cardiotoxic effects that are not related to nicotine, such as a hypercoagulable state that can persist approximately one week after smoking.35
The limitations of our study include the facts that it was almost completely restricted to male veterans and that it was not possible to verify the smoking status of the subjects at the time of the occurrence of adverse events. Given our sample size we cannot exclude the possibility of an approximately 5 percent increase in primary and secondary end points due to treatment, or of small differences in the long-term rates of smoking cessation. This small potential risk should be considered in the context of the known benefits of smoking cessation in patients with cardiovascular disease.
It should not be expected that therapy with transdermal nicotine would increase the risk of adverse events in patients with cardiac disease according to the dose of nicotine delivered. Plasma nicotine levels, even in patients using full-dose transdermal delivery systems, are likely to be lower than those of the average smoker.36 On average, patch users who continue smoking smoke fewer cigarettes.13 In addition, the flattening out of the dose–response curve for the cardiac effects of nicotine provides a safeguard against effects associated with slight elevations in nicotine levels, should they occur.37 Moreover, smoking causes a rapid rise in plasma nicotine levels, with higher peak levels in arterial blood than in venous blood; patches, by contrast, effect a gradual rise in nicotine levels and only minimal arterial–venous differences.38 Therefore, transdermal nicotine is likely to be safer for the cardiovascular system than inhaled nicotine, because the relatively stable blood nicotine levels associated with the patches sustain the body's tolerance with respect to the drug's sympathomimetic effects.
It is advisable to caution all patients not to smoke while using patches; studies of cessation demonstrate that even occasional smoking during replacement therapy is predictive of long-term failure to quit smoking.39 Provided there is still a reasonable chance that patients can manage to abstain from tobacco, however, our data do not demonstrate a need for instructing them to stop patch use immediately if they “slip” and smoke during treatment.
These data suggest that concern about the use of nicotine-replacement therapy for smokers with cardiovascular disease is not warranted. Nicotine has pharmacologic effects that may contribute to cardiotoxicity, but transdermal nicotine therapy is likely to be less dangerous to a patient than smoking, because it does not increase thrombogenesis, decrease oxygen-carrying capacity, or lead to atherogenesis. Because the majority of patients with cardiac disease, peripheral vascular disease, and cerebrovascular disease have been given repeated advice to stop smoking but have still been unsuccessful in numerous attempts, every safe technique should be made available to help them quit, including the use of transdermal nicotine.
We are indebted to Helen Roemhild, Pam Werb, and the study coordinators at all the sites for their assistance in the recruitment of subjects and the conduct of this trial; and to the members of the Data and Safety Monitoring Board: Dr. Frank Lederle, Dr. Gordon Pierpont, and Dr. Dorothy Hatsukami.
Source Information
From the Department of Medicine, Veterans Affairs (VA) Medical Center and University of Minnesota, Minneapolis (A.M.J.); the Department of Psychology, VA Medical Center, Kansas City, Mo. (S.M.N.); the Department of Medicine, VA Medical Center, Loma Linda, Calif. (L.H.F.); the Department of Medicine, VA Medical Center, Denver (A.V.P.); the Department of Medicine, VA Medical Center, Durham, N.C. (E.C.W.); the Nursing Service, VA Medical Center, Seattle (B.G.S.); the Primary Ambulatory Care and Education Center, VA Medical Center, Sepulveda, Calif. (S.E.S.); the Department of Medicine, VA Medical Center, Portland, Oreg. (M.C.); the Psychology Service, VA Medical Center, Reno, Nev. (D.O.A.); the Department of Psychiatry, VA Medical Center, Los Angeles (N.H.); and the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (P.G.M.).
Address reprint requests to Dr. Joseph at the Section of General Internal Medicine (111-0), Veterans Affairs Medical Center, 1 Veterans Dr., Minneapolis, MN 55417.
- References
References
1
Department of Health and Human Services. The health consequences of smoking: cardiovascular disease: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1983. (DHHS publication no. (PHS) 84-50204.)
2
Idem. The health benefits of smoking cessation: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1990. (DHHS publication no. (CDC) 90-8416.)
3
Fiore MC ,Smith SS ,Jorenby DE ,Baker TB . The effectiveness of the nicotine patch for smoking cessation: a meta-analysis. JAMA 1994;271:1940-1947
CrossRef | Web of Science | Medline4
Fiore MC, Bailey WC, Cohen SJ, et al. Smoking cessation: clinical practice guideline no. 18. Washington, D.C.: Government Printing Office, 1996. (AHCPR publication no. 96-0692.)
5
Working Group for the Study of Transdermal Nicotine in Patients with Coronary Artery Disease
CrossRef | Web of Science | Medline6
Benowitz NL . Pharmacologic aspects of cigarette smoking and nicotine addiction. N Engl J Med 1984;319:1318-13307
Kaijser L ,Berglund B . Effect of nicotine on coronary blood-flow in man. Clin Physiol 1985;5:541-552
CrossRef | Medline8
Allred EN ,Bleecker ER ,Chaitman BR , et al. Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. N Engl J Med 1989;321:1426-1432[Erratum, N Engl J Med 1990;322:1019.]
Full Text | Web of Science | Medline9
Benowitz NL ,Fitzgerald GA ,Wilson M ,Zhang Q . Nicotine effectson eicosanoid formation and hemostatic function: comparison of trans-dermal nicotine and cigarette smoking. J Am Coll Cardiol 1993;22:1159-1167
CrossRef | Web of Science | Medline10
Allen SS ,Hatsukami D ,Gorsline J . Cholesterol changes in smoking cessation using the transdermal nicotine system: Transdermal Nicotine Study Group. Prev Med 1994;23:190-196
CrossRef | Web of Science | Medline11
Morrow JD ,Frei B ,Longmire AW , et al. Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers: smoking as a cause of oxidative damage. N Engl J Med 1995;332:1198-1203
Full Text | Web of Science | Medline12
Gillum RF ,Ingram DD ,Makuc DM . White blood cell count and stroke incidence and death: the NHANES I epidemiologic follow-up study. Am J Epidemiol 1994;139:894-902
Web of Science | Medline13
Transdermal Nicotine Study Group
CrossRef | Web of Science14
Joseph AM ,Westman EC . Transdermal nicotine therapy for older, medically ill patients: a pilot study. J Gen Intern Med 1995;10:Suppl:101-101 abstract.15
Anthonisen NR ,Connett JE ,Kiley JP , et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study. JAMA 1994;272:1497-1505
CrossRef | Web of Science | Medline16
Rigotti NA ,Eagle KA . Atrial fibrillation while chewing nicotine gum. JAMA 1986;255:1018-1018
CrossRef | Web of Science | Medline17
Stewart PM ,Catterall JR . Chronic nicotine ingestion and atrial fibrillation. Br Heart J 1985;54:222-223
CrossRef | Web of Science | Medline18
Dacosta A ,Guy JM ,Tardy B , et al. Myocardial infarction and nicotine patch: a contributing or causative factor? Eur Heart J 1993;14:1709-1711
CrossRef | Web of Science | Medline19
Warner JG Jr ,Little WC . Myocardial infarction in a patient who smoked while wearing a nicotine patch. Ann Intern Med 1994;120:695-695
Web of Science | Medline20
Ottervanger JP ,Festen JM ,de Vries AG ,Stricker BH . Acute myocardial infarction while using the nicotine patch. Chest 1995;107:1765-1766
CrossRef | Web of Science | Medline21
Hwang SL, Waldholt M. Heart attacks reported in patch users still smoking. Wall Street Journal. June 19, 1992:B1.
22
Fredrickson PA ,Hurt RD ,Lee GM , et al. High dose transdermal nicotine therapy for heavy smokers: safety, tolerability and measurement of nicotine and cotinine levels. Psychopharmacology 1995;122:215-222
CrossRef | Web of Science | Medline23
Pierce JR Jr . Stroke following application of a nicotine patch. Ann Pharmacother 1994;28:402-402
Web of Science | Medline24
Jackson M . Cerebral arterial narrowing with nicotine patch. Lancet 1993;342:236-237
CrossRef | Web of Science | Medline25
Arnaot MR . Treating heart disease: nicotine patches may not be safe. BMJ 1995;310:663-664
CrossRef | Web of Science | Medline26
Clearing the air: how to quit smoking . . . and quit for keeps. Bethesda, Md.: National Cancer Institute, 1993. (NIH publication no. 95-1647.)
27
Why do you smoke? Bethesda, Md.: National Cancer Institute, 1993. (NIH publication no. 94-1822.)
28
Tar, nicotine and carbon monoxide content of the smoke of 475 varieties of domestic cigarettes. Washington, D.C.: Federal Trade Commission, 1991.
29
Fagerstrom KO ,Schneider NG . Measuring nicotine dependence: a review of the Fagerström Tolerance Questionnaire. J Behav Med 1989;12:159-182
CrossRef | Web of Science | Medline30
SAS/STAT user's guide, version 6. 4th ed. Vols. 1 and 2. Cary, N.C.: SAS Institute, 1989.
31
Taylor CB ,Houston-Miller N ,Killen JD ,DeBusk RF . Smoking cessation after acute myocardial infarction: effects of a nurse-managed intervention. Ann Intern Med 1990;113:118-123
Web of Science | Medline32
Rigotti NA ,McKool KM ,Shiffman S . Predictors of smoking cessation after coronary artery bypass graft surgery: results of a randomized trial with 5-year follow-up. Ann Intern Med 1994;120:287-293
Web of Science | Medline33
DeBusk RF ,Miller NH ,Superko HR , et al. A case-management system for coronary risk factor modification after acute myocardial infarction. Ann Intern Med 1994;120:721-729
Web of Science | Medline34
Frid D ,Ockene IS ,Ockene JK , et al. Severity of angiographically proven coronary artery disease predicts smoking cessation. Am J Prev Med 1991;7:131-135
Web of Science | Medline35
FitzGerald GA ,Oates JA ,Nowak J . Cigarette smoking and hemostatic function. Am Heart J 1988;115:267-271
CrossRef | Web of Science | Medline36
Henningfield JE . Nicotine medications for smoking cessation. N Engl J Med 1995;333:1196-1203
Full Text | Web of Science | Medline37
Benowitz NL ,Jacob P III . Intravenous nicotine replacement suppresses nicotine intake from cigarette smoking. J Pharmacol Exp Ther 1990;254:1000-1005
Web of Science | Medline38
Henningfield JE ,Stapleton JM ,Benowitz NL ,Grayson RF ,London ED . Higher levels of nicotine in arterial than in venous blood after cigarette smoking. Drug Alcohol Depend 1993;33:23-29
CrossRef | Web of Science | Medline39
Kenford SL ,Fiore MC ,Jorenby DE ,Smith SS ,Wetter D ,Baker TB . Predicting smoking cessation: who will quit with and without the nicotine patch. JAMA 1994;271:589-594
CrossRef | Web of Science | Medline
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Michael B. Siegel, Kerry L. Tanwar, Kathleen S. Wood. (2011) Electronic Cigarettes As a Smoking-Cessation Tool. American Journal of Preventive Medicine 40:4, 472-475
CrossRef13
David B. Seder, J. Michael Schmidt, Neeraj Badjatia, Luis Fernandez, Fred Rincon, Jan Claassen, Errol Gordon, Emmanuel Carrera, Pedro Kurtz, Kiwon Lee, E. Sander Connolly, Stephan A. Mayer. (2011) Transdermal Nicotine Replacement Therapy in Cigarette Smokers with Acute Subarachnoid Hemorrhage. Neurocritical Care 14:1, 77-83
CrossRef14
Alex Bobak, Saul Shiffman, Joseph G Gitchell, John Bery, Stuart G Ferguson. (2010) Perceived Safety of Nicotine and the Use of Nicotine Replacement Products Among Current Smokers in Great Britain: Results From Two National Surveys. The Journal of Smoking Cessation 5:2, 115-122
CrossRef15
J. Taylor Hays, Jon O. Ebbert. (2010) Adverse Effects and Tolerability of Medications for the Treatment of Tobacco Use and Dependence. Drugs 70:18, 2357-2372
CrossRef16
Victor Aboyans, Daniel Thomas, Philippe Lacroix. (2010) The cardiologist and smoking cessation. Current Opinion in Cardiology 22:5, 469-477
CrossRef17
Alan H. Gradman, Nosheen Javed. 2010. Addictive Disorders in Cardiovascular Medicine. , 251-275.
CrossRef18
Lisa J. Merlo, Kimberly G. Blumenthal, Kendall Campbell, Morrow Omli, Mark S. Gold. 2010. Pharmacological Therapeutics for Relapse Reduction in Addictive Disorders. , 503-523.
CrossRef19
James H. Black. (2010) Evidence base and strategies for successful smoking cessation. Journal of Vascular Surgery 51:6, 1529-1537
CrossRef20
Mark J. Eisenberg, Lisa M. Blum, Kristian B. Filion, Stephane Rinfret, Louise Pilote, Gilles Paradis, Lawrence Joseph, André Gervais, Jennifer O’Loughlin. (2010) The efficacy of smoking cessation therapies in cardiac patients: A meta-analysis of randomized controlled trials. Canadian Journal of Cardiology 26:2, 73-79
CrossRef21
B. J. Apelberg, G. Onicescu, E. Avila-Tang, J. M. Samet. (2010) Estimating the Risks and Benefits of Nicotine Replacement Therapy for Smoking Cessation in the United States. American Journal of Public Health 100:2, 341-348
CrossRef22
Kathleen F Harrington, William C Bailey. (2009) Smoking cessation through the utilization of pharmacotherapy. Expert Review of Respiratory Medicine 3:5, 475-485
CrossRef23
Stuart G. Ferguson, Joseph G. Gitchell, Saul Shiffman, Mark A. Sembower. (2009) Prediction of abstinence at 10 weeks based on smoking status at 2 weeks during a quit attempt: Secondary analysis of two parallel, 10-week, randomized, double-blind, placebo-controlled clinical trials of 21-mg nicotine patch in adult smokers. Clinical Therapeutics 31:9, 1957-1965
CrossRef24
Anne N Thorndike, Nancy A Rigotti. (2009) A tragic triad: coronary artery disease, nicotine addiction, and depression. Current Opinion in Cardiology 24:5, 447-453
CrossRef25
F. Costa, R. Soares. (2009) Nicotine: A pro-angiogenic factor. Life Sciences 84:23-24, 785-790
CrossRef26
D. J. Ossip, S. M. Abrams, M. C. Mahoney, D. Sall, K. M. Cummings. (2009) Adverse effects with use of nicotine replacement therapy among quitline clients. Nicotine & Tobacco Research 11:4, 408-417
CrossRef27
Neal L. Benowitz. (2009) Pharmacology of Nicotine: Addiction, Smoking-Induced Disease, and Therapeutics. Annual Review of Pharmacology and Toxicology 49:1, 57-71
CrossRef28
Michael A. Chandler, Stephen I. Rennard. 2009. Smoking Cessation. , 599-607.
CrossRef29
Thomas F. Rehring, Ryan S. Stolcpart, H. Whitton Hollis. (2008) Pharmacologic risk factor management in peripheral arterial disease: A vade mecum for vascular surgeons. Journal of Vascular Surgery 47:5, 1108-1115
CrossRef30
Sunny Kaul. 2008. Smoking Cessation. , 65-83.
CrossRef31
Dionysios Adamopoulos, Philippe van de Borne, Jean Francois Argacha. (2008) NEW INSIGHTS INTO THE SYMPATHETIC, ENDOTHELIAL AND CORONARY EFFECTS OF NICOTINE. Clinical and Experimental Pharmacology and Physiology 35:4, 458-463
CrossRef32
John Britton, Richard Edwards. (2008) Tobacco smoking, harm reduction, and nicotine product regulation. The Lancet 371:9610, 441-445
CrossRef33
Jürgen Barth, Julia A Critchley, Jürgen Bengel, Jürgen Barth. 2008. Psychosocial interventions for smoking cessation in patients with coronary heart disease. .
CrossRef34
Lindsay F Stead, Rafael Perera, Chris Bullen, David Mant, Tim Lancaster, Lindsay F Stead. 2008. Nicotine replacement therapy for smoking cessation. .
CrossRef35
Tim Lancaster, Lindsay Stead, Kate Cahill. (2008) An update on therapeutics for tobacco dependence. Expert Opinion on Pharmacotherapy 9:1, 15-22
CrossRef36
Daniel M. Doolan, Nancy A. Stotts, Neil L. Benowitz, Kenneth E. Covinsky, Erika S. Froelicher. (2008) The Women's Initiative for Nonsmoking (WINS) XI: Age-Related Differences in Smoking Cessation Responses Among Women With Cardiovascular Disease. The American Journal of Geriatric Cardiology 17:1, 37-47
CrossRef37
Maher Karam-Hage, Paul M. Cinciripini. (2007) Pharmacotherapy for tobacco cessation: Nicotine agonists, antagonists, and partial agonists. Current Oncology Reports 9:6, 509-516
CrossRef38
Lynn T. Kozlowski, Gary A. Giovino, Beth Edwards, Joseph DiFranza, Jonathan Foulds, Richard Hurt, Raymond Niaura, David P.L. Sachs, Peter Selby, Katherine M. Dollar, Deborah Bowen, K. Michael Cummings, Mona Counts, Brion Fox, David Sweanor, Frank Ahern. (2007) Advice on using over-the-counter nicotine replacement therapy-patch, gum, or lozenge-to quit smoking. Addictive Behaviors 32:10, 2140-2150
CrossRef39
J. Cornuz. (2007) Smoking Cessation Interventions in Clinical Practice. European Journal of Vascular and Endovascular Surgery 34:4, 397-404
CrossRef40
Atsuhiko Sugimoto, Haruchika Masuda, Masamichi Eguchi, Hideki Iwaguro, Teruhisa Tanabe, Takayuki Asahara. (2007) Nicotine Enlivenment of Blood Flow Recovery Following Endothelial Progenitor Cell Transplantation into Ischemic Hindlimb. Stem Cells and Development 16:4, 649-656
CrossRef41
Robert D Reid, Bonnie Quinlan, Dana L Riley, Andrew L Pipe. (2007) Smoking cessation: lessons learned from clinical trial evidence. Current Opinion in Cardiology 22:4, 280-285
CrossRef42
Amy H. Lee, Bekele Afessa. (2007) The association of nicotine replacement therapy with mortality in a medical intensive care unit. Critical Care Medicine 35:6, 1517-1521
CrossRef43
David O. Warner. (2007) Tobacco control for anesthesiologists. Journal of Anesthesia 21:2, 200-211
CrossRef44
Nicole Lindenblatt, Uwe Platz, Jörn Hameister, Ernst Klar, Michael D. Menger, Brigitte Vollmar. (2007) Distinct effects of acute and chronic nicotine application on microvascular thrombus formation and endothelial function in male and female mice. Langenbeck's Archives of Surgery 392:3, 285-295
CrossRef45
Jon O. Ebbert, Amit Sood, J Taylor Hays, Lowell C. Dale, Richard D. Hurt. (2007) Treating Tobacco Dependence: Review of the Best and Latest Treatment Options. Journal of Thoracic Oncology 2:3, 249-256
CrossRef46
A. Diehl, K. Mann. (2007) Pharmakologische Rückfallprävention bei Alkohol- und Tabakabhängigkeit. Der Internist 48:1, 79-88
CrossRef47
(2007) Traitement médicamenteux du diabète de type 2recommandation de bonne pratique. Diabetes & Metabolism 33:1, S26-S105
CrossRef48
&NA;. (2006) Choosing the form of nicotine replacement therapy (NRT) based on the individual smoker??s needs and preferences may improve abstinence rates. Drugs & Therapy Perspectives 22:12, 15-18
CrossRef49
Robyn L. Richmond, Nicholas Zwar, Rowena Ivers. 2006. Tobacco and Cardiovascular Disease. , 647-688.
CrossRef50
Jürgen Barth, Jürgen Bengel, Julia Critchley. (2006) Efficacy of psychosocial interventions for smoking cessation in patients with coronary heart disease: a systematic review and meta-analysis. Annals of Behavioral Medicine 32:1, 10-20
CrossRef51
S. Tonstad, J. A. Johnston. (2006) Cardiovascular risks associated with smoking: a review for clinicians. European Journal of Cardiovascular Prevention & Rehabilitation 13:4, 507-514
CrossRef52
Michael D. Stein, Bradley J. Anderson, Raymond Niaura. (2006) Nicotine Replacement Therapy: Patterns Of Use After A Quit Attempt Among Methadone-Maintained Smokers. Journal of General Internal Medicine 21:7, 753-757
CrossRef53
Robert Nilsson. (2006) De Minimus Non Curat Lex - Virtual Thresholds for Cancer Initiation by Tobacco Specific Nitrosamines - Prospects for Harm Reduction by Smokeless Tobacco. International Journal of Occupational Medicine and Environmental Health 19:1, 6-35
CrossRef54
Afshin Assadian, Romana Rotter, Christian Senekowitsch, Ojan Assadian, Georg W. Hagmüller, Michael Kunze. (2006) Prevalence of patients continuing to smoke after vascular interventions. Wiener klinische Wochenschrift 118:7-8, 212-216
CrossRef55
Jacques Cornuz. (2006) Treating tobacco use and dependence in clinical practice. Expert Opinion on Pharmacotherapy 7:6, 783-792
CrossRef56
William H. Frishman, Walter Mitta, Adam Kupersmith, Tom Ky. (2006) Nicotine and Non-nicotine Smoking Cessation Pharmacotherapies. Cardiology in Review 14:2, 57-73
CrossRef57
Louise C. W. Wiggers, Ellen M. A. Smets, Frans J. Oort, Hanneke C. J. M. Haes, Marja N. Storm-Versloot, Hester Vermeulen, Dink A. Legemate, Lucas B. M. Loenen, Ron J. G. Peters. (2006) Adherence to nicotine replacement patch therapy in cardiovascular patients. International Journal of Behavioral Medicine 13:1, 79-88
CrossRef58
David O. Warner. (2006) Perioperative Abstinence from Cigarettes. Anesthesiology 104:2, 356-367
CrossRef59
Jennifer B McClure, Gary E Swan. (2006) Tailoring Nicotine Replacement Therapy. CNS Drugs 20:4, 281-291
CrossRef60
Martha L Daviglus, Donald M Lloyd-Jones, Amber Pirzada. (2006) Preventing Cardiovascular Disease in the 21st Century. American Journal of Cardiovascular Drugs 6:2, 87-101
CrossRef61
2006. Nicotine replacement therapy. , 2508-2511.
CrossRef62
Saul Shiffman, Deborah M. Scharf, William G. Shadel, Chad J. Gwaltney, Qianyu Dang, Stephanie M. Paton, Duncan B. Clark. (2006) Analyzing Milestones in Smoking Cessation: Illustration in a Nicotine Patch Trial in Adult Smokers.. Journal of Consulting and Clinical Psychology 74:2, 276-285
CrossRef63
T. Heitzer, T. Meinertz. (2005) Rauchen und koronare Herzkrankheit. Zeitschrift für Kardiologie 94:S3, iii30-iii42
CrossRef64
Howard S. Marsh, Carolyn M. Dresler, Jae H. Choi, Darren A. Targett, Michael L. Gamble, Kenneth R. Strahs. (2005) Safety profile of a nicotine lozenge compared with thatof nicotine gum in adult smokers with underlying medical conditions: A 12-week, randomized, open-label study. Clinical Therapeutics 27:10, 1571-1587
CrossRef65
L.C.W. Wiggers, P.F.M. Stalmeier, F.J. Oort, E.M.A. Smets, D.A. Legemate, J.C.J.M. de Haes. (2005) Do patients' preferences predict smoking cessation?. Preventive Medicine 41:2, 667-675
CrossRef66
B. L. W. BENDERMACHER, E. M. WILLIGENDAEL, J. A. W. TEIJINK, M. H. PRINS. (2005) Medical management of peripheral arterial disease. Journal of Thrombosis and Haemostasis 3:8, 1628-1637
CrossRef67
C. L. Ford, J. A. Zlabek. (2005) Nicotine Replacement Therapy and Cardiovascular Disease. Mayo Clinic Proceedings 80:5, 652-656
CrossRef68
Jacques Medioni, Ivan Berlin, Alain Mallet. (2005) Increased risk of relapse after stopping nicotine replacement therapies: a mathematical modelling approach. Addiction 100:2, 247-254
CrossRef69
S. Khan, M. Cleanthis, J. Smout, M. Flather, G. Stansby. (2005) Life-style Modification in Peripheral Arterial Disease. European Journal of Vascular and Endovascular Surgery 29:1, 2-9
CrossRef70
Kanjana Suriyaprom, Rungsunn Tungtrongchitr, Praneet Pongpaew, Benjaluck Phonrat, Talabporn Harnroongroj, Niyomsri Vudhivai, Anchalee Tungtrongchitr, Suporn Paksanont, Somchai Pooudong, Frank Peter Schelp. (2005) Homocysteine and vitamin status in healthy Thai smokers. Journal of Nutritional and Environmental Medicine 15:1, 9-21
CrossRef71
Athanasios Stoyioglou, Michael R. Jaff. (2004) Medical Treatment of Peripheral Arterial Disease: A Comprehensive Review. Journal of Vascular and Interventional Radiology 15:11, 1197-1207
CrossRef72
C Silagy, T Lancaster, L Stead, D Mant, G Fowler, Lindsay Stead. 2004. Nicotine replacement therapy for smoking cessation. .
CrossRef73
K Chou. (2004) The effectiveness of nicotine-patch therapy for smoking cessation in patients with schizophrenia. International Journal of Nursing Studies 41:3, 321-330
CrossRef74
L.C.W Wiggers, E.M.A Smets, J.C.J.M de Haes, R.J.G Peters, D.A Legemate. (2003) Smoking Cessation Interventions in Cardiovascular Patients. European Journal of Vascular and Endovascular Surgery 26:5, 467-475
CrossRef75
Rowena G. Ivers, Melissa Farrington, Chris B. Burns, Ross S. Bailie, Peter H. D'Abbs, Robyn L. Richmond, Eric Tipiloura. (2003) A study of the use of free nicotine patches by Indigenous people. Australian and New Zealand Journal of Public Health 27:5, 486-490
CrossRef76
S.D Hobbs, A.W Bradbury. (2003) Smoking Cessation Strategies in Patients with Peripheral Arterial Disease: An Evidence-based Approach. European Journal of Vascular and Endovascular Surgery 26:4, 341-347
CrossRef77
M BOGENSCHUTZ, C GEPPERT. (2003) Pharmacologic treatments for women with addictions. Obstetrics and Gynecology Clinics of North America 30:3, 523-544
CrossRef78
K. P. FAGERSTROM, E.-B. SCHILDT. (2003) Reply to the comments on Fagerstrom & Schildt. Addiction 98:9, 1204-1205
CrossRef79
Tomasz M Ziedalski, Viji Sankaranarayanan, Rajinder K Chitkara. (2003) Advances in the management of chronic obstructive pulmonary disease. Expert Opinion on Pharmacotherapy 4:7, 1063-1082
CrossRef80
Jean-François Etter, Jacques le Houezec, Björn Landfeldt. (2003) Impact of messages on concomitant use of nicotine replacement therapy and cigarettes: a randomized trial on the Internet. Addiction 98:7, 941-950
CrossRef81
D.R. Lewis, J.F. Bolton, S. Hebard, F.C. Smith, R.N. Baird, P.M. Lamont. (2003) Risk Factor Documentation in Elective and Emergency Vascular Surgical Admissions. European Journal of Vascular and Endovascular Surgery 25:6, 568-572
CrossRef82
Jun Suzuki, Evelyn Bayna, Erminia Dalle Molle, Wilbur Y.W Lew. (2003) Nicotine inhibits cardiac apoptosis induced by lipopolysaccharide in rats. Journal of the American College of Cardiology 41:3, 482-488
CrossRef83
Neal L Benowitz. (2003) Basic cardiovascular research and its implications for the medicinal use of nicotine. Journal of the American College of Cardiology 41:3, 497-498
CrossRef84
Rohit Ahuja, Sandra B. Weibel, Frank T. Leone. (2003) Lung cancer: The oncologist's role in smoking cessation. Seminars in Oncology 30:1, 94-103
CrossRef85
Anne M Joseph, Steven S Fu. (2003) Smoking Cessation for Patients with Cardiovascular Disease. American Journal of Cardiovascular Drugs 3:5, 339-349
CrossRef86
David O. Antonuccio, William G. Danton, Terry Michael McClanahan. (2003) Psychology in the Prescription Era: Building a Firewall Between Marketing and Science.. American Psychologist 58:12, 1028-1043
CrossRef87
K Abdenbi. (2002) L’arrêt du tabac chez le coronarien. Annales de Cardiologie et d'Angéiologie 51:6, 357-366
CrossRef88
Richard A. Rosin, Martin D. Levine, Elaine Peskind. (2002) Transdermal Nicotine for Agitation in Dementia. American Journal of Geriatric Psychiatry 9:4, 443-444
CrossRef89
P. Burns, E. Lima, A.W. Bradbury. (2002) What Constitutes Best Medical Therapy for Peripheral Arterial Disease?. European Journal of Vascular and Endovascular Surgery 24:1, 6-12
CrossRef90
Beth C. Bock, Bruce Becker. (2002) Smoking Cessation. Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine 1:2, 116-128
CrossRef91
Richard D Hurt, Jon O Ebbert. (2002) Preventing lung cancer by stopping smoking. Clinics in Chest Medicine 23:1, 27-36
CrossRef92
Rigotti, Nancy A., . (2002) Treatment of Tobacco Use and Dependence. New England Journal of Medicine 346:7, 506-512
Full Text93
Thomas Neunteufl, Sandra Heher, Karam Kostner, Goran Mitulovic, Stephan Lehr, Gholamali Khoschsorur, Rainer W Schmid, Gerald Maurer, Thomas Stefenelli. (2002) Contribution of nicotine to acute endothelial dysfunction in long-term smokers. Journal of the American College of Cardiology 39:2, 251-256
CrossRef94
G. F. X. Feeney, A. McPherson, J. P. Connor, A. McAlister, R. M. Young, P. Garrahy. (2001) Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction. Internal Medicine Journal 31:8, 470-475
CrossRef95
William H. Frishman, Tom Ky, Anjum Ismail. (2001) Tobacco Smoking, Nicotine, and Nicotine and Non-Nicotine Replacement Therapies. Heart Disease365-377
CrossRef96
Anne M. Joseph, Lawrence C. An. (2001) Tobacco smoking in patients with cardiovascular disease. Current Treatment Options in Cardiovascular Medicine 3:4, 313-322
CrossRef97
Stephen E Kimmel, Jesse A Berlin, Carolyn Miles, Jane Jaskowiak, Jeffrey L Carson, Brian L Strom. (2001) Risk of acute first myocardial infarction and use of nicotine patches in a general population. Journal of the American College of Cardiology 37:5, 1297-1302
CrossRef98
M. Eccles. (2001) Evidence-based guideline for the primary care management of stable angina. Family Practice 18:2, 217-222
CrossRef99
Maria O Paganelli, Jose E Tanus-Santos, Juan C.Y Toledo, Joaquim Francisco do Prado, Vivian Calegari, Heitor Moreno. (2001) Acute administration of nicotine impairs the hypotensive responses to bradykinin in rats. European Journal of Pharmacology 413:2-3, 241-246
CrossRef100
&NA;. (2000) Don't forget nicotine replacement therapy in smokers with cardiovascular disease. Drugs & Therapy Perspectives 16:4, 4-6
CrossRef101
J. Taylor Hays. (2000) Tobacco Dependence Treatment in Patients With Heart and Lung Disease: Implications for Intervention and Review of Pharmacological Therapy. Journal of Cardiopulmonary Rehabilitation 20:4, 215-223
CrossRef102
Neal L. Benowitz, Margaret Wilson Peng. (2000) Non-Nicotine Pharmacotherapy for Smoking Cessation. CNS Drugs 13:4, 265-285
CrossRef103
Michael G. Goldstein, Raymond Niaura. (2000) METHODS TO ENHANCE SMOKING CESSATION AFTER MYOCARDIAL INFARCTION. Medical Clinics of North America 84:1, 63-80
CrossRef104
Alain Nitenberg, Isabelle Antony. (1999) Effects of Nicotine Gum on Coronary Vasomotor Responses During Sympathetic Stimulation in Patients with Coronary Artery Stenosis. Journal of Cardiovascular Pharmacology 34:5, 694-699
CrossRef105
Joseph, Anne M., , Antonuccio, David O., . (1999) Lack of Efficacy of Transdermal Nicotine in Smoking Cessation. New England Journal of Medicine 341:15, 1157-1158
Full Text106
MICHAEL W. OWENS, BOAZ A. MARKEWITZ, D. KEITH PAYNE. (1999) Outpatient Management of Chronic Obstructive Pulmonary Disease. The American Journal of the Medical Sciences 318:2, 79
CrossRef107
Gregory Dalack, James Meador-Woodruff. (1999) Acute feasibility and safety of a smoking reduction strategy for smokers with schizophrenia. Nicotine & Tobacco Research 1:1, 53-57
CrossRef108
Joy Schmitz, Ralph Spiga, Howard Rhoades, Francisco Fuentes, John Grabowski. (1999) Smoking cessation in women with cardiac risk: A comparative study of two theoretically based therapies. Nicotine & Tobacco Research 1:1, 87-94
CrossRef109
David Wood, Guy De Backer, Ole Faergeman, Ian Graham, Giuseppe Mancia, Kalevi Pyörälä. (1998) Prevention of coronary heart disease in clinical practice: Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention1European Society of Cardiology, European Atherosclerosis Society, European Society of Hypertension, International Society of Behavioural Medicine, European Society of General Practice/Family Medicine, European Heart Network.1,2Published simultaneously in the European Heart Journal 1998;19:1434–1503 and the Journal of Hypertension (Summary only) 1998;16(10).2. Atherosclerosis 140:2, 199-270
CrossRef110
. (1998) Zijn nicotinepleisters veilig bij hartpatiënten?. Medisch-Farmaceutische Mededelingen 36:9, 204-204
CrossRef111
Shoshana Zevin, Peyton Jacob, Neal L. Benowitz. (1998) Dose-related cardiovascular and endocrine effects of transdermal nicotine*. Clinical Pharmacology & Therapeutics 64:1, 87-95
CrossRef112
Melanie Wakefield, Lyn Roberts, Ellie Rosenfeld. (1998) Prospects for smoking cessation among people with insulin-dependent diabetes. Patient Education and Counseling 34:3, 257-266
CrossRef113
Daniela Lucini, Federico Bertocchi, Alberto Malliani, Massimo Pagani. (1998) Autonomic Effects of Nicotine Patch Administration in Habitual Cigarette Smokers: A Double-Blind, Placebo-Controlled Study Using Spectral Analysis of RR Interval and Systolic Arterial Pressure Variabilities. Journal of Cardiovascular Pharmacology 31:5, 714-720
CrossRef114
Jack E. Henningfield, Lakshmi Gopalan, Saul Shiffman. (1998) Tobacco dependence. Current Opinion in Psychiatry 11:3, 259-263
CrossRef115
S. Shiffman, K. M. Mason, J. E. Henningfield. (1998) TOBACCO DEPENDENCE TREATMENTS: Review and Prospectus. Annual Review of Public Health 19:1, 335-358
CrossRef116
Stephen F. Lewis, Thomas M. Piasecki, Michael C. Fiore, Jane E. Anderson, Timothy B. Baker. (1998) Transdermal Nicotine Replacement for Hospitalized Patients: A Randomized Clinical Trial. Preventive Medicine 27:2, 296-303
CrossRef117
Kazunari Usuki, Takuro Kanekura, Kazuhiro Aradono, Tamotsu Kanzaki. (1998) Effects of nicotine on peripheral cutaneous blood flow and skin temperature. Journal of Dermatological Science 16:3, 173-181
CrossRef118
Hans Peter Brunner-La Rocca, Jakob Schneider, Andreas K??nzli, Marko Turina, Wolfgang Kiowski. (1998) CARDIAC ALLOGRAFT REJECTION LATE AFTER TRANSPLANTATION IS A RISK FACTOR FOR GRAFT CORONARY ARTERY DISEASE. Transplantation 65:4, 538-543
CrossRef119
Sandeep Vijan, Deryth L. Stevens, William H. Herman, Martha M. Funnell, Connie J. Standiford. (1997) Screening, Prevention, Counseling, and Treatment for the Complications of Type II Diabetes Mellitus Putting Evidence into Practice. Journal of General Internal Medicine 12:9, 567-580
CrossRef120
Kelly G. Wilson. (1997) The revolution to come. Behavior Therapy 28:4, 597-600
CrossRef121
Neal L. Benowitz. (1997) The Role of Nicotine in Smoking-Related Cardiovascular Disease. Preventive Medicine 26:4, 412-417
CrossRef122
Neal L Benowitz, Steven G Gourlay. (1997) Cardiovascular Toxicity of Nicotine: Implications for Nicotine Replacement Therapy. Journal of the American College of Cardiology 29:7, 1422-1431
CrossRef
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