We know combination medications worked better than monotherapies in the Wisconsin Smokers Health Study. But, to quote a typical three-year-old, “Why?”

UW-CTRI research published in the Journal of Consulting Clinical Psychology confirms that it’s largely due to greater craving suppression. Dan Bolt, Megan
Piper, Wendy Theobald and Tim Baker contributed to the paper.

The univariate models suggested that the combination treatments produced higher abstinence rates than the monotherapies because of greater suppression of withdrawal, craving, and smoking expectations. However, multiple mediator models showed that the suppression of craving on the quit day produced the strongest mediational effects and could account for the mediational effects of other tested variables. Conclusion: Higher abstinence rates for combination therapy versus monotherapies appear primarily due to greater craving suppression.

Anecdotally, patients who quit with the help of combination therapy said the nicotine patch gave them a steady stream of nicotine to temper overall cravings, and having the gum or lozenge nearby was calming and useful when a strong urge arose.

Stevens Smith and Kate Kobinsky are submitting a separate paper showing increased effectiveness of combination medications used through the Wisconsin Tobacco Quit Line in comparison to monotherapy.

Bolt DM, Piper ME, Theobald WE, Baker TB. Why Two Smoking Cessation Agents Work Better Than One: Role of Craving Suppression. Journal of Consulting Clinical Psychology. [Epub Ahead of print]