[Improved product characteristics of nicotine gums: an unexplored area for higher compliance with nicotine replacement therapy]

OBJECTIVE

To assess consumer acceptance of new flavoured nicotine gums in comparison with existing nicotinegums.

METHOD

A total of 607 adult smokers who intended to cut down or give up smoking were included in two randomised, single-blind, central location, acceptance tests. A new fruit-flavoured nicotine gum (Gum A = Nicorette Freshfruit) was compared with an existing fruit-flavoured nicotine gum (Gum B = Nicotinell fruit), and a new menthol-flavoured gum (Gum N = Nicorette Icy White) was compared with two existing mint-flavoured gums (Gum M = Nicotinell mint; Gum Q = NiQuitin mint). For all gums, the nicotine 2 mg and 4 mg strengths were tested. Each subject compared two of the nicotine gums, either 2 mg or 4 mg and either fruit-flavoured or menthol/ mint-flavoured, and assessed several characteristics, including sweetness, flavour, crunchiness, and overall liking, at predefined intervals.

RESULTS

For the fruit-flavoured gums the percentage of subjects who rated sweetness and flavour to be "just right"after 5 minutes of chewing was significantly higher for Gum A than for Gum B at both strengths. Comparison of the mint/menthol-flavoured gums revealed significantly superior ratings for Gum N over both Gum M and Gum Q. With regard to expectations of which gum would be more likely help quit smoking, significantly more participants expressed greater confidence in Gum A than Gum B for the fruit-flavoured gums. Similarly, for the mint/menthol-flavoured gums significantly more subjects had greater confidence in Gum N than Gum Mor Gum Q.

CONCLUSIONS

Product characteristics of nicotine gums, such as crunchiness, sweetness and flavour, appear to be crucial for the expectations that smokers have in the likelihood that any particular nicotine gum will help them to quit smoking. Thus, improved organoleptic characteristics of nicotine gums may lead to higher compliance, resulting in higher plasma nicotine levels and thereby in a higher quit rate.

Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

Education of tobacco use prevention and cessation for dental professionals--a paradigm shift

The use of tobacco continues to be a substantial risk factor in the development and progression of oral cancer, periodontitis, implant failure and poor wound healing. Dental and dental hygiene education providers have made great advances towards the incorporation of tobacco education into their curricula in recent years. Unfortunately, however, both medical and dental education research has consistently reported schools providing only basic knowledge-based curricula that rarely incorporate more effective, behaviourally-based components affecting long-term change. The limited training of oral healthcare students, at least in part, is reflected in practising dental professionals continuing to report offering incomplete tobacco interventions. In order to prepare the next generation of oral healthcare providers, this paper proposes a paradigm shift in how tobacco use prevention and cessation (TUPAC) may be incorporated into existing curricula. It is suggested that schools should carefully consider: to what level of competency should TUPAC be trained in dental and dental hygiene schools; the importance of establishing rapport through good communication skills; the core knowledge level for TUPAC; suggested instructional and assessment strategies; the importance of continuing professional education for the enhancement of TUPAC.