A Randomized, controlled trial to compare the effectiveness of nortriptyline plus brief motivation counseling and motivation counseling alone for smoking cessation in Thai active smokers

Abstract

Objective: To determine the smoking abstinence rate at 3 months in Thai active smokers who use nortriptyline combined with brief motivational counseling or brief motivational counseling alone for smoking cessation. Design: Double blind randomized controlled trial. Setting: smoking cessation clinic, Faculty of Medicine, Chulalongkorn University. Method: Active smoking (more than 10 cigarettes per day) who was older than 18 years and are willing to quit smoking were randomized into control group and treatment group. Control group received brief motivation counseling and placebo. Treatment group received nortriptyling 50 mg/day and brief intervention counseling. Patients were followed up for 3 months. Success rate of smoking cessation and other secondary outcomes at 3 months were evaluated. Result: There were 68 patients in control group and 69 patients in treatment group. There were no statistically significant difference in baseline demographic data and smoking history in 2 groups. Smoking cessation rate at 3 month rate was higher in treatment group than in control group 43.5% vs 26.5% respectively, p = 0.014, OR = 2.5 95% CI 1.19-5.25). Patients received nortriptyline experienced more side effect of dry mouth than in control group. Conclusion: Nortriptyline and brief motivational counseling was more effective in smoking cessation treatment than brief motivational counseling alone at 3 months after treatment and related with minor side effects from treatment.