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May 23, 1990

A Trial of Clonidine to Stop Smoking

Author Affiliations

Veterans Administration Medical Center Portland, Ore

Veterans Administration Medical Center Portland, Ore

JAMA. 1990;263(20):2746. doi:10.1001/jama.1990.03440200048010

To the Editor.—  Highly dependent smokers, as defined by Fagerstrom tolerance scores of 7 and above, often have more severe withdrawal syndromes and lower quit rates than mildly or intermediately dependent smokers.1,2 It is recommended that these highly dependent smokers receive more intensive support in the form of behavioral modification classes and counseling.2 Also, use of nicotine gum raises long-term verified quit rates in this group.3 However, nicotine gum does not appear to be effective (and is not recommended by the manufacturer) without the patient's active participation in a behavioral modification program.4 Even with these treatment regimens, long-term verified quit rates in highly dependent smokers are low, ranging from 6% to 44%.3As Franks et al5 point out in their article entitled "Randomized, Controlled Trial of Clonidine for Smoking Cessation in a Primary Care Setting," clonidine hydrochloride therapy by itself without an intensive