Can glucose tablets help you quit smoking?
But this is more than just a theory. Professor West has published a series of studies supporting the role of glucose tablets in reducing cigarette cravings and helping smokers to quit. These have included fairly large randomized placebo-controlled trials (which found that glucose tablets were at least as effective as the nicotine patch for smoking cessation), and placebo-controlled experimental studies which found that the glucose tablets reduced cigarette cravings. The data on glucose has not all been totally consistent. For example, a colleague and I published a paper a few years ago showing no significant effect of glucose tablets on cigarette cravings.
But just this month, Professor West published his biggest trial of glucose tablets for smoking cessation, in the journal, Psychopharmacology. In this study 928 smokers were randomly allocated to receive either glucose tablets or sorbitol (placebo) tablets to help them quit. During this study in the UK, the UK government approved the used of NRT and bupropion as covered medicines in the UK National Health Service. As a result, about half of the people in the study also used an approved smoking cessation medicine. So when the results were analyzed they examined those who only used counseling plus glucose/sorbitol tablets, and separately analyzed those who used another medicine (plus counseling), plus either glucose or sorbitol. The results were a little puzzling.
The 6-month quite rate was no higher for those receiving glucose tablets only (10.7%) as compared to those who only received sorbitol tablets (14.3%). However , among the 474 smokers who received NRT or bupropion (mainly nicotine patch or gum), those who were also given glucose tablets had a significantly higher quit rate (18.2%) as compared with those given placebo tablets, (12.2%). These results are puzzling to me, as I might have expected the effects of glucose to be higher when the person had no other medications, when they were the opposite.
So what does all this mean? First of all, it seems likely that any effect of glucose in helping a smoker to quit may be quite small…it is no wonder-cure. But my view is that there are enough studies out there with evidence of a clinically useful effect of glucose on cigarette craving and cessation, to warrant further studies. Part of the reason this could be useful is that glucose tablets are so cheap compared to most medicines. Another is that for some medicines it would be useful to have an adjunct that could be added on if craving became a severe problem.
For now, the evidence may not be sufficient to start advising smokers routinely to use glucose tablets. However, it seems clear that going on a low calorie weight loss diet when trying to quit smoking is probably not the best combination.
West R et al (2010). A randomized trial of glucose tablets to aid smoking cessation. Psychopharmacology, 207, 631-637.