PURPOSE: Since January 2004, the AMI Stop Smoking Clinic has been combining counseling in conjunction with an anticholinergic intramuscular injection (SMART Shot®) to help alleviate the symptoms of nicotine withdrawal and aide in smoking cessation in over 1000 patients.
METHODS: Between January 2004 and January 2005, 1000 patients enrolled in a smoking cessation program utilizing a single anticholinergic intramuscular injection comprised of scopolamine and hydroxyzine (SMART Shot®) followed by oral and/or transdermal scopolamine for an additional one week, in conjunction with a dedicated counseling program. Patients smoking status and side effect profile at various times were obtained by our staff of counselors, psychologist and/or the treating physician.
RESULTS: The number of patients who provided follow up information were 654 of 1000 (65%), 329 of 743 (44%), 167 of 545 (31%) and 57 of 200 eligible patients at 1,3,6 and 12 months respectively. The self reported smoking cessation rates were 546 of 654 (83%), 246 of 329 (75%), 109 of 167 (65%), and 29 of 57 (51%) at 1,3,6 and 12 months respectively. The major side effects in these 1000 patients were dry mouth (frequency not reported), restless legs or “fitful” night after the shot 86, nausea 37, blurry vision 26 patients, vomiting 4, agitation 4, urinary retention 1. 63 patients had to have the medications discontinued or reduced. There were two emergency room visits; one patient with urinary retention and one patient with disorientation.
CONCLUSION: These data, though impressive, is incomplete. The interpretation of the data is limited by the partial patient follow up data. The side effect profile though acceptable, was obtained from patient records and was not directly asked on routine patient interviews. Thus these data may underreport the true incidence. We conclude that an anticholinergic intramuscular injection (SMART Shot®) is potentially a safe and effective adjunct to a well designed smoking cessation program.
CLINICAL IMPLICATIONS: This method of smoking cessation deserves further investigation with a well designed, controlled clinical trial.
DISCLOSURE: Kirk Voelker, Shareholder AMI Stop Smoking Clinics; Product/procedure/technique that is considered research and is NOT yet approved for any purpose, Scopolamine and hydroxyzine are not FDA approved for smoking cessation.