Skip to main content
PMC home page
Thorax logoLink to Thorax
. 2002 Aug;57(8):715–718. doi: 10.1136/thorax.57.8.715

Controlled trial of three weeks nicotine replacement treatment in hospital patients also given advice and support

S Hand 1, S Edwards 1, I Campbell 1, R Cannings 1
PMCID: PMC1746389  PMID: 12149533

Abstract

Background: Smoking is a major public health issue, estimated as causing 120 000 deaths in the UK per year. Smoking cessation is an important aspect of the treatment of many diseases. Nicotine replacement therapy (NRT) has been shown to increase cessation rates among healthy volunteers and in general practice, but it is not clear whether it has an effect in hospital patients.

Methods: Patients referred by their hospital doctor to the smoking cessation counsellor and who agreed to participate in the study were randomised to receive either NRT given as a nicotine patch daily and a nicotine inhalator on an as needed basis plus advice and support (AS+NRT), or to receive just advice and support (AS). Claims of smoking cessation were validated at 1 week, 3 months, 6 months, and 1 year by carbon monoxide (CO) breath testing.

Results: A total of 245 patients were randomised, 136 AS+NRT and 109 AS. There were no significant demographic differences between the two groups at baseline. At 1 year 35 (14%) had sustained cessation confirmed by a CO breath test, 20/136 (15%) AS+NRT and 15/109 (14%) AS, p=0.857. One hundred and ten patients gave up smoking for at least 1 week, 54% AS+NRT and 33% AS (p<0.001). By 6 months there was no significant difference between the two groups (22/136 (16%) AS+NRT and 15/109 (14%) AS).

Conclusion: In hospital patients NRT, given as regular daily patches plus an inhalator to be used as needed, did not add to the smoking cessation rate achieved at 1 year by regular advice and support, despite significantly increasing the cessation rate at 1 week.

Full Text

The Full Text of this article is available as a PDF (98.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blondal T., Gudmundsson L. J., Olafsdottir I., Gustavsson G., Westin A. Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up. BMJ. 1999 Jan 30;318(7179):285–288. doi: 10.1136/bmj.318.7179.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Campbell I. A., Prescott R. J., Tjeder-Burton S. M. Smoking cessation in hospital patients given repeated advice plus nicotine or placebo chewing gum. Respir Med. 1991 Mar;85(2):155–157. doi: 10.1016/s0954-6111(06)80295-7. [DOI] [PubMed] [Google Scholar]
  3. Campbell I. A., Prescott R. J., Tjeder-Burton S. M. Transdermal nicotine plus support in patients attending hospital with smoking-related diseases: a placebo-controlled study. Respir Med. 1996 Jan;90(1):47–51. doi: 10.1016/s0954-6111(96)90244-9. [DOI] [PubMed] [Google Scholar]
  4. Campbell I. A. Smoking cessation. Thorax. 2000 Aug;55 (Suppl 1):S28–S31. doi: 10.1136/thorax.55.suppl_1.s28. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fiore M. C., Smith S. S., Jorenby D. E., Baker T. B. The effectiveness of the nicotine patch for smoking cessation. A meta-analysis. JAMA. 1994 Jun 22;271(24):1940–1947. [PubMed] [Google Scholar]
  6. Fisher E. B. Prediction, causation, description, and natural history of smoking cessation. Addiction. 1996 Sep;91(9):1285–1287. doi: 10.1111/j.1360-0443.1996.tb03612.x. [DOI] [PubMed] [Google Scholar]
  7. Foulds J., Stapleton J., Hayward M., Russell M. A., Feyerabend C., Fleming T., Costello J. Transdermal nicotine patches with low-intensity support to aid smoking cessation in outpatients in a general hospital. A placebo-controlled trial. Arch Fam Med. 1993 Apr;2(4):417–423. doi: 10.1001/archfami.2.4.417. [DOI] [PubMed] [Google Scholar]
  8. Gourlay S. G., Forbes A., Marriner T., Pethica D., McNeil J. J. Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation. BMJ. 1994 Oct 1;309(6958):842–846. doi: 10.1136/bmj.309.6958.842. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hays J. T., Croghan I. T., Schroeder D. R., Offord K. P., Hurt R. D., Wolter T. D., Nides M. A., Davidson M. Over-the-counter nicotine patch therapy for smoking cessation: results from randomized, double-blind, placebo-controlled, and open label trials. Am J Public Health. 1999 Nov;89(11):1701–1707. doi: 10.2105/ajph.89.11.1701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hjalmarson A., Nilsson F., Sjöström L., Wiklund O. The nicotine inhaler in smoking cessation. Arch Intern Med. 1997 Aug 11;157(15):1721–1728. [PubMed] [Google Scholar]
  11. Jarvis M. J., Raw M., Russell M. A., Feyerabend C. Randomised controlled trial of nicotine chewing-gum. Br Med J (Clin Res Ed) 1982 Aug 21;285(6341):537–540. doi: 10.1136/bmj.285.6341.537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lewis S. F., Piasecki T. M., Fiore M. C., Anderson J. E., Baker T. B. Transdermal nicotine replacement for hospitalized patients: a randomized clinical trial. Prev Med. 1998 Mar-Apr;27(2):296–303. doi: 10.1006/pmed.1998.0266. [DOI] [PubMed] [Google Scholar]
  13. Naidoo B., Stevens W., McPherson K. Modelling the short term consequences of smoking cessation in England on the hospitalisation rates for acute myocardial infarction and stroke. Tob Control. 2000 Dec;9(4):397–400. doi: 10.1136/tc.9.4.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Peto R., Darby S., Deo H., Silcocks P., Whitley E., Doll R. Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. BMJ. 2000 Aug 5;321(7257):323–329. doi: 10.1136/bmj.321.7257.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Prathiba B. V., Tjeder S., Phillips C., Campbell I. A. A smoking cessation counsellor: should every hospital have one? J R Soc Promot Health. 1998 Dec;118(6):356–359. doi: 10.1177/146642409811800614. [DOI] [PubMed] [Google Scholar]
  16. Raw M., McNeill A., West R. Smoking cessation: evidence based recommendations for the healthcare system. BMJ. 1999 Jan 16;318(7177):182–185. doi: 10.1136/bmj.318.7177.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schneider N. G., Olmstead R., Nilsson F., Mody F. V., Franzon M., Doan K. Efficacy of a nicotine inhaler in smoking cessation: a double-blind, placebo-controlled trial. Addiction. 1996 Sep;91(9):1293–1306. [PubMed] [Google Scholar]
  18. Stapleton J. A., Russell M. A., Feyerabend C., Wiseman S. M., Gustavsson G., Sawe U., Wiseman D. Dose effects and predictors of outcome in a randomized trial of transdermal nicotine patches in general practice. Addiction. 1995 Jan;90(1):31–42. doi: 10.1046/j.1360-0443.1995.901316.x. [DOI] [PubMed] [Google Scholar]
  19. Stapleton J. Commentary: Progress on nicotine replacement therapy for smokers. BMJ. 1999 Jan 30;318(7179):289–289. [PubMed] [Google Scholar]
  20. Tønnesen P., Nørregaard J., Mikkelsen K., Jørgensen S., Nilsson F. A double-blind trial of a nicotine inhaler for smoking cessation. JAMA. 1993 Mar 10;269(10):1268–1271. [PubMed] [Google Scholar]
  21. Wilson K., Gibson N., Willan A., Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med. 2000 Apr 10;160(7):939–944. doi: 10.1001/archinte.160.7.939. [DOI] [PubMed] [Google Scholar]
  22. Yudkin P. L., Jones L., Lancaster T., Fowler G. H. Which smokers are helped to give up smoking using transdermal nicotine patches? Results from a randomized, double-blind, placebo-controlled trial. Br J Gen Pract. 1996 Mar;46(404):145–148. [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES