New developments in NRT
NRT was developed in the early 70s. The first product
was the gum in strengths of 2 and 4 mg, approved first
in CH 1978 and in UK 1979. The skin patches were introduced
in the early 90s. Thereafter, with the exception of the
nasal spray, a number of me-to-products, in terms of efficacy
and pharmacokinetic profile, have been introduced (sublingual
tablet, inhalator and lozenges).
More recently some new products (gum, lollipop and mouth
spray) with a faster delivery of nicotine that somewhat
better mimics what the smoker is used to from the cigarettes
have been developed. Very recently a nicotine pill for
swallowing has also been tested pharmacokinetically.
However also new ways of using NR are emerging. Introducing
NR 1 to 3 weeks before actual quitting seem to boost success
rates and combining several NR products is also likely
to increase success rates, particularly for more dependent
smokers. For smokers failing a quit attempt or for those
unable or unwilling to make a quit attempt using NR as
an aid to reduce smoking may increase motivation and self
efficacy and finally produce cessation.
Karl Fagerström studied at the University of Uppsala
and graduated as a licensed clinical psychologist 1975.
At that time he started to run a smoking cessation clinic.
In 1981 he got his Ph.D. on a dissertation about nicotine
dependence and smoking cessation.
In the end of the seventies and early eighties he served
as the editor-in-chief for the Scandinavian Journal for
From 1983 through 1997 he worked for Pharmacia and Upjohn
as Director of Scientific Information for Nicotine Replacement
Products. He has worked with the nicotine gum Nicorette
since 1975 and has been contributing to NRT developments
such as patch, spray and inhaler. Ever since 1975 he has
been working clinically part-time.
Currently he works with his own private consultancy (Fagerström
Consulting and the Smokers Information Center). He is
a founding member of the Society for Research on Nicotine
He started the European affiliate in 1999 of which he
has been the president up to 2003. In 2003 he also became
president elect of the mother SRNT. His main research
contributions have been in the fields of Behaviour Medicine,
Tobacco and Nicotine with over 100 peer reviewed publications
of which he is the first author of 75. The current main
interest is on reducing harm and exposure to tobacco toxins
among all those who can not give up smoking. He has given
the name to a nicotine dependence scale (The Fagerström
Test For Nicotine Dependence) and was awarded the WHO
medal 1999 for outstanding work in tobacco control.
The Smokers' Information Centre, Helsingborg, Sweden