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Craving control using nicotine replacement therapy in a teaching hospital
1Respiratory Unit and Pharmacy Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia. terry.jones@health.sa.gov.au
Internal Medicine Journal
|March 20, 2010
Summary
Nicotine replacement therapy effectively reduced cravings and smoking in hospitalized patients. Both nicotine patch and inhaler increased interest in quitting after discharge, improving hospital environments.
Area of Science:
- Clinical Medicine
- Pharmacology
- Public Health
Background:
- Hospitalization represents a significant period of nicotine abstinence for smokers, often leading to cravings.
- Cravings can result in patients smoking on hospital premises, impacting facility image and potentially patient health.
- Nicotine replacement therapy (NRT) is a potential intervention to manage cravings and support smoking cessation during hospital stays.
Purpose of the Study:
- To compare the effectiveness of two NRT formulations (nicotine patch and inhaler) in managing inpatient nicotine cravings.
- To assess the impact of NRT on patients' enthusiasm for quitting smoking post-discharge.
- To evaluate patient preference between nicotine patch and inhaler formulations.
Main Methods:
- Smokers admitted to the hospital were randomized to receive either a nicotine patch or inhaler.
- Patients chose their preferred NRT formulation for the duration of their hospital stay.
- Craving control, formulation preference, and post-discharge quitting interest were measured using visual analogue scales (VAS) and a 3-point scale, with abstinence confirmed by exhaled breath carbon monoxide (CO) monitoring.
Main Results:
- The nicotine patch was preferred by 64% of participants.
- Both NRT formulations significantly reduced cravings (mean VAS score decreased from 7.5 to 1.7) and decreased instances of patients smoking on hospital grounds (from 37% to 5%).
- Interest in quitting smoking post-discharge increased, and mean daily nicotine exposure from NRT was lower than from cigarettes prior to hospitalization.
Conclusions:
- Nicotine replacement therapy, particularly the patch, is effective in reducing cravings and smoking among hospitalized patients.
- NRT increases patients' motivation to quit smoking after discharge and improves the hospital environment by reducing on-campus smoking.
- Hospitals and other institutions with enforced prolonged abstinence should provide NRT to all inpatients.
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