Women wanting to quit smoking may be better off trying a nicotine inhaler rather than nicotine gum, and men may be better advised to approach it the other way around, that is, trying the gum rather than inhaler.

Otherwise, however, whether would-be quitters get their preferred form of nicotine replacement therapy-or the type selected for them-does not apparently affect outcome. This is regardless of their initial preferences and could be because as people get used to particular products, they come to like then. Simple comparison of success rates between these products has been reported previously. However, this multi-centre study examined factors linked with preference for, and effectiveness of, the four different nicotine replacement products -- gum, patch, nasal spray and inhaler. The 504 smokers participating in this study were asked to rank the four products in order of personal preference and then randomly assigned to receive one of the products for a quit-smoking attempt. Follow-ups were done at one, four, 12 and 15 weeks later, and ratings of the products were repeated one week after the quit date. Mood and physical symptoms were assessed at baseline and at each follow-up visit, and urges to smoke were assessed at all post-quit date sessions. Abstinence was assessed by self-report, with verification by expired air carbon monoxide. Although initially, the patch was most popular, followed by the spray, inhaler and gum in that order, with the difference greater in women than men, all participants quickly came to like whichever product had been assigned to them. Prior experience with the gum was linked with lower initial preference for it but did not affect outcome, and prior experience with the patch had no effect on preference or outcome. Nor did use of the preferred product increase success at quitting smoking. Among highly dependent smokers, those on the inhaler had a lower relapse rate than those on other products. Contributing to this study were researchers from St. George's Hospital Medical School, St. Bartholomew's and the Royal London Hospitals School of Medicine and Dentistry, all of London, England; Pharmacia & Upjohn, Helsingborg, Sweden; and University of Medicine and Dentistry, New Jersey, United States.

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