EFFECT OF METFORMIN ON NICOTINE WITHDRAWAL SYNDROME REDUCTION AND NICOTINE ABSTINENCE INCREASING, A DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL; THE RESULTS OF 12-MONTH FOLLOW-UP

Background and Aim : Smoking was a risk factor for six deaths of every eight deaths in the world. Metformin was the first line for diabetes treatment, and had been shown to be used for the nicotine withdrawal syndrome reduction. Methods : In a randomized double-blind placebo-controlled trial during February 2015 to May 2016, 53 male and female smokers who were volunteered for smoking cessation in Tehran were selected through a respondent-driven sampling method, and were randomly assigned to two experiment and control groups through computer-generated random numbers. Metformin or placebo was prescribed as escalating doses. All participants received Brief Behavioral Compliance Enhancement Treatment (BBCET). Nicotine withdrawal syndrome, urinary cotinine levels, and exhaled carbon monoxide (eCO) level were evaluated in the repeated measured form. The data were analyzed by Generalized Estimation Equation (GEE), Chi-square, and Atlas-Ti5. Results : The primary outcomes showed that the metformin group had a significant improvement in depression, anxiety, cravings, stimulation-enthusiasm, and difficulty in concentration during 12 weeks of treatment (all p s<0.05). Meanwhile, two components of appetite-weight (p<0.04) and insomnia (p<0.01) were associated with drop in scores. In addition, only cravings scores remained constant until the follow-up year (p<0.04). Secondary outcomes demonstrated that urinary cotinine levels and eCO level decreased significantly in the metformin group (all p s<0.05). However, this decrease was not remained constant at both levels until the follow-up year (P> 0.05). Conclusion : Metformin was an effective therapy and it had a clinical potential for reducing the nicotine withdrawal. However, finding the results of increasing insomnia required further studies

Keywords:

Metformin , Smoking Cessation , Nicotine Withdrawal