Repository corticotropin injection as an adjunct to smoking cessation during the initial nicotine withdrawal period: results from a family practice clinic.

Fifteen white patients participated in this study of a family-practice-based smoking cessation program in which corticotropin (ACTH) was used to assist patients during the first one to two weeks of abstinence from nicotine. All patients were habitual smokers who had made one or more attempts to quit smoking before entering this program. Treatment consisted of three single intramuscular injections of ACTH. In most cases, declining doses of 160, 80, and 40 U were administered at three-day intervals. The decision to provide additional treatment was based on the response by each volunteer and the investigator's judgment. The mean duration of follow-up was 33 days (range, 17 to 49 days), with the exception of two patients, who have just recently completed therapy. Evidence supporting complete smoking cessation or a significant reduction (80% to greater than 90%) in the number of cigarettes smoked per day was achieved in 13 of the 15 patients. The single nonresponder expressed an initial interest in the program, but showed a lack of motivation thereafter. There was insufficient follow-up on one other patient, who has not been available for monitoring since completion of therapy. Symptoms associated with the tobacco withdrawal syndrome that were reported by the patients included mild irritability and restlessness.