SMOKING

Clinical trial comparing nicotine replacement therapy (NRT) plus brief counselling, brief counselling alone, and minimal intervention on smoking cessation in hospital inpatients

A Molyneux¹, S Lewis¹, U Leivers¹, A Anderton¹, M Antoniak¹, A Brackenridge³, F Nilsson⁴, A McNeill³, R West³, J Moxham², J Britton¹

¹ Division of Respiratory Medicine, University of Nottingham, City Hospital Nottingham, UK
² Guy’s, King’s and St Thomas’ School of Medicine, London, UK
³ Department of Psychology, St George’s Hospital Medical School, London, UK
⁴ Pharmacia Consumer Healthcare, Medical Affairs, Helsingborg, Sweden.

Correspondence to:
Correspondence to:
Dr A Molyneux, Division of Respiratory Medicine, University of Nottingham, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK;
andrew.molyneux{at}nottingham.ac.uk

Background: Guidelines recommend that smoking cessation interventions are offered in all clinical settings to all smokers willing to make a quit attempt. Since the effectiveness of routine provision of behavioural counselling and nicotine replacement therapy (NRT) to smokers admitted to hospital has not been established, a randomised controlled trial of these interventions given together compared with counselling alone or minimal intervention was performed in hospital inpatients.

Methods: Medical and surgical inpatients who were current smokers at the time of admission were randomised to receive either usual care (no additional advice at admission), counselling alone (20 minute intervention with written materials), or NRT plus counselling (counselling intervention with a 6 week course of NRT). Continuous and point prevalence abstinence from smoking (validated by exhaled carbon monoxide <10 ppm) was measured at discharge from hospital and at 3 and 12 months, and self-reported reduction in cigarette consumption in smokers was assessed at 3 and 12 months.

Results: 274 inpatient smokers were enrolled. Abstinence was higher in the NRT plus counselling group (n=91) than in the counselling alone (n=91) or usual care (n=92) groups. The difference between the groups was significant for validated point prevalence abstinence at discharge (55%, 43%, 37% respectively, p=0.045) and at 12 months (17%, 6%, 8%, p=0.03). The respective differences in continuous validated abstinence at 12 months were 11%, 4%, 8% (p=0.25). There was no significant difference between counselling alone and usual care, or in reduction in cigarette consumption between the treatment groups.

Conclusions: NRT given with brief counselling to hospital inpatients is an effective routine smoking cessation intervention.

Keywords: smoking cessation; nicotine replacement therapy; hospital inpatients

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2003 58: 463. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Lewis, K. E., Durgan, L., Edwards, V. M., Dixon, H., Whitehead, C., Sykes, R. N. (2009). Can smokers switch from a hospital-based to a community-based stop smoking service? An open-label, randomized trial comparing three referral schemes. Nicotine Tob Res 11: 756-764 [Abstract] [Full Text]  
• Mottillo, S., Filion, K. B., Belisle, P., Joseph, L., Gervais, A., O'Loughlin, J., Paradis, G., Pihl, R., Pilote, L., Rinfret, S., Tremblay, M., Eisenberg, M. J. (2009). Behavioural interventions for smoking cessation: a meta-analysis of randomized controlled trials. Eur Heart J 30: 718-730 [Abstract] [Full Text]  
• Rigotti, N. A., Munafo, M. R., Stead, L. F. (2008). Smoking Cessation Interventions for Hospitalized Smokers: A Systematic Review. Arch Intern Med 168: 1950-1960 [Abstract] [Full Text]  
• Schmelzle, J., Rosser, W. W., Birtwhistle, R. (2008). Update on pharmacologic and nonpharmacologic therapies for smoking cessation. cfp 54: 994-999 [Abstract] [Full Text]  
• Rovina, N., Nikoloutsou, I., Dima, E., Michailidou, M., Roussos, C., Gratziou, C. (2007). Smoking cessation treatment in a real-life setting: the Greek experience. Ther Adv Respir Dis 1: 93-104 [Abstract]  
• Bednarek, M, Gorecka, D, Wielgomas, J, Czajkowska-Malinowska, M, Regula, J, Mieszko-Filipczyk, G, Jasionowicz, M, Bijata-Bronisz, R, Lempicka-Jastrzebska, M, Czajkowski, M, Przybylski, G, Zielinski, J (2006). Smokers with airway obstruction are more likely to quit smoking. Thorax 61: 869-873 [Abstract] [Full Text]  
• (2005). Spoken sessions. Thorax 60: ii4-ii52 [Full Text]  
• (2004). Other articles noted: 25 Jul 03 to 7 Nov 03. Evid. Based Nurs. 7: e1-1 [Full Text]  
• Campbell, I (2003). Nicotine replacement therapy in smoking cessation. Thorax 58: 464-465 [Full Text]