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. Author manuscript; available in PMC: 2018 Jun 8.
Published in final edited form as: Curr Psychiatr. 2018 Jun;17(6):30–55.

Table 4.

NAC for the treatment of tobacco use disorder

Study Sample Dosing Outcomes
McClure et al30 (2014) N = 116 adolescents (age 15 to 21) with cannabis dependence (72% male, 84% white; 59% smokers) 1,200 mg twice daily (2,400 mg/d) vs placebo for 8 weeks (double-blind) added to contingency management No group differences in reported cigarettes smoked
Froeliger et al31 (2015) N = 16 adult smokers (69% male; 56% black/African American, 44% white) 1,200 mg twice daily (2,400 mg/d) vs placebo for 3.5 days (double- blind)

  • NAC group more likely to maintain abstinence during 3.5-day monetarily-incentivized abstinence period, as evidenced by lower carbon monoxide values

  • NAC group reported decreased craving and higher positive affect relative to placebo group
Prado et al32 (2015) N = 34 outpatients with therapy-resistant tobacco use disorder (26.5% male) 1,500 mg twice daily (3,000 mg/d) vs placebo for 12 weeks (double-blind) NAC group reported fewer cigarettes and had lower carbon monoxide levels at end of treatment, compared with placebo group
Knackstedt et al33 (2009) N = 33 adults with nicotine dependence (58% male; 70% white, 21% black/African American) 1,200 mg twice daily (2,400 mg/d) vs placebo for 4 weeks (double-blind)

  • When excluding 2 heavy drinkers from analysis, the NAC group reported fewer cigarettes smoked per day than the control group

  • No group differences in carbon monoxide levels

  • No group differences in self- reported craving or withdrawal
Grant et al34 (2014) N = 28 adults with nicotine dependence and pathological gambling (82% male; 82% white) 1,200 to 3,000 mg/d (titrated based on clinician’s judgment) vs placebo for 12 weeks (double-blind) NAC group reported fewer symptoms of nicotine dependence in first half of treatment
Schmaal et al35 (2011) N = 22 undergraduate smokers (41% male) 1,800 mg twice daily for 3 days (3,600 mg/d) and once on Day 4 (1,800 mg) vs placebo (double-blind)

  • No group differences in self- reported craving

  • A trend for the NAC group to report reduced withdrawal symptoms

  • Post-treatment cigarette smoked in the laboratory was rated as less rewarding by the NAC group, compared with the placebo group
Bernardo et al36 (2009) N = 75 adults with bipolar disorder (30% male; 45% smokers) 1,000 mg twice daily (2,000 mg/d) vs placebo for 6 months (double-blind) No group differences in self-reported frequency of tobacco use

NAC: N-acetylcysteine