Glucose for smoking cessation: does it have a role?

Nicotine replacement therapies and amfebutamone (bupropion) have both been shown to aid smoking cessation. However, even with the best support most attempts to stop smoking fail, and many smokers prefer not to use medications in their quit attempts. Oral dextrose (glucose) has been proposed as a possible aid to smoking cessation which would be very inexpensive and might be used by some smokers as well as or instead of medications. It is hypothesised that single doses of nicotine relieve hunger in smokers so that over time smokers therefore come, in certain situations, to interpret sensations associated with hunger as craving for a cigarette. Adaptation to long term nicotine intake leads to exacerbation of these sensations during periods of abstinence. Chewing dextrose tablets results in a rapid increase in blood glucose levels that would be expected to yield a small reduction in these sensations which might then translate into a reduction in craving. An intervention that reduced craving might help smokers to maintain abstinence. Placebo-controlled studies have provided some support for the hypothesis that chewing glucose tablets can reduce desire to smoke during abstinence, and the one adequately powered study carried out so far found that glucose tablets increased 1-month abstinence rates significantly compared with a placebo. Definitive trials are now required but, given their low cost, glucose tablets may be a useful aid for some smokers.