SUNDAY, March 4 (HealthScout) -- Two hits of nicotine are better than one if you want to quit smoking, new research shows.

A French study suggests smokers may have a better chance to beat their bad habit with a nicotine inhaler and a patch instead of just an inhaler. At six weeks, 60.5 percent of those who used the combination had quit, while only 47.5 percent of those who used an inhaler alone had stopped, the study finds. At 12 weeks, the numbers were 42 percent and 31 percent, respectively. After a year, it was 19.5 percent and 14 percent. The study, conducted at the French National Institute of Health and Medical Research, appears in a recent issue of the Archives of Internal Medicine. Worldwide, tobacco causes 3.5 million deaths a year, or one death every nine seconds, statistics show. The World Health Organization predicts that by 2020, annual tobacco-related deaths will exceed deaths from AIDS, traffic accidents, murder, suicide, illegal drugs and alcohol combined. The U.S. Department of Health and Human Services says about 70 percent of all smokers say they want to quit. The French study, conducted between March 1996 and February 1998 in Nice, included 400 adults, aged 18 to 70, who smoked 10 or more cigarettes a day for three or more years. The subjects had an expired carbon monoxide level of 10 parts per million or greater, had tried at least one previous time to quit and wanted to stop smoking. "Combining this sort of inhaler with a patch, to my knowledge, has never been done before," says Dr. Alexander Glassman, chief of clinical psychopharmacology and professor of psychiatry at Columbia University. But he says previous studies combined other types of nicotine treatments and achieved better results than single-source nicotine therapies. "You're going to have higher nicotine levels in those people who take nicotine from two routes," Glassman says. "All the data would suggest that the more nicotine you give, the more likely you are to help somebody," he says. The same results could be achieved by using a larger nicotine patch, Glassman says. He says the study adds to the literature that shows combined treatments are more effective than single treatments. Glassman says too few doctors consider double nicotine treatments for patients who want to quit smoking. "Even though it isn't brand new, it's under-utilized. (The study) focuses attention on something that's been seen before but ignored," he says. The majority of tobacco users quit without nicotine replacement therapy, says Robert W. Moon, manager of tobacco control for the American Cancer Society. He says behavior therapy is also a valuable tool. "Treatments involving person-to-person contact via individual, group or proactive telephone counseling are consistently effective, and the effectiveness increases with treatment intensity," Moon says. "If the (study) results are accurate, the combination of pharmacotherapies could be added to the other effective therapies for smoking cessation that might be offered to all patients attempting to quit," he says.

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