Table 2 Summary of Fagerstrom & Hughes review of the safety of smoking and concomitant NRT use[37]

Foulds et al, 1992

16+ cigarettes per day (cpd) & 15 milligram (mg) transdermal patch (TP) over 16 hrs

Baseline: 37 nanograms per millilitre (ng/ml), Placebo: 36 ng/ml, 15 mg TP: 44 ng/ml.

Participants experienced almost no subjective toxic effects whilst wearing the patch

Pickworth, Bunker & Henningfield, 1994

13+ cpd & 22 mg, 44 mg TP over 24 hrs

Baseline: 30 ng/ml, Placebo: 19 ng/ml,

22 mg TP: 39 ng/ml,

44 mg TP: 63 ng/ml.

No adverse subjective experiences were reported.

Mahmarian et al, 1997

8+ cpd & 14 mg TP over 24 hrs

Baseline 16 ng/ml, 14 mg TP: 24 ng/ml, 21 mg TP: 30 ng/ml.

Only adverse effects noted were nausea & vomiting in 2 patients.

Zevin, Jacob & Benowitz, 1998

Smoking ad libitum & 21 mg, 42 mg, 63 mg patch over 8 hours

Placebo: 20 ng/ml, 63 mg TP: 60 ng/ml.

No additional haemodynamic effects of TP on heart rate, blood pressure, noradrenaline, white blood cell count, fibrinogen, haematocrit, cortisol, or lipids. No adverse reactions.

Carpenter et al, 2000

11+ cpd & TP, gum or inhaler

Lower than 22 mg TP: 54% increase, Higher than 22 mg TP: 190% increase.

Number of cpd reduced by 43% and CO by 31%.