Transdermal nicotine replacement for hospitalized smokers
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: The US Surgeon General has identified smoking as the single largest cause of premature loss of life in the United States. It has been estimated that more than 400,000 deaths occur each year in this country as a result of tobacco use. Recent data indicate that approximately one in four America are current smokers. Because of the large disease burden associated with cigarette smoking, decreasing the percentage of Americans who smoke is an important public health goal.
 
 
 
 
 
 There are at least 6.5 million adult smokers hospitalized yearly in the US, providing doctors and health educators a window of opportunity to reach smokers with smoking cessation inter-ventions. Patients are often hospitalized for a smoking-related illness, may not be able to smoke while hospitalized because of restrictive smoking policies, and may, therefore, be more open to quitting smoking. To date, relatively few controlled clinical trials have examined whether hospital-based smoking cessation interventions are effective in helping smokers quit.
 
 
 
 
 
 The Smoking Cessation Research Group at the San Francisco VA Medical Center recently completed one of the largest hospital-based smoking cessation clinical trials. A total of 324 smokers received intensive counseling or minimal counseling during hospitalization for noncardiac surgery. Participants in the intensive intervention group also had the option to receive nicotine replacement therapy on an out-patient basis. The results of this study, which have been accepted for publication. In the Archives of Internal Medicine, demonstrated that such a behavioral modification intervention could double the rate of smoking cessation compared with a minimal counseling intervention.
 
 
 
 
 
 Because the effectiveness of the nicotine patch for in-patient smoking cessation has not been studied previously, we propose a clinical trial In which all study participants will receive the nicotine patch during their hospitalization. Use of the nicotine patch will continue for 2 months. In addition, participants will be randomly assigned to receive either intensive counseling or minimal counseling. If minimal counseling and the nicotine patch results in a quit rate that is similar to that achieved by intensive counseling and the nicotine patch, we would recommend that hospitalized smokers who want to quit smoking receive the patch and the less intensive intervention first, reserving the more intensive counseling for out-patient smokers who require more individualized attention.
 
 
 
 
 
 Although 40 million Americans have quit smoking, approximately 50 million continue to smoke. Effective, economical, targeted smoking cessation and relapse prevention programs that are capable of reaching millions of American smokers who are hospitalized each year have the potential to decrease the burden of disease, disability, and death resulting from tobacco use. The effectiveness of the nicotine patch combined with counseling when used in hospital-based programs needs to be evaluated to define the role of the patch in this setting. The proposed study would be an important contribution to this relatively understudied area of smoking cessation research.