Factors associated with nicotine replacement therapy use among hospitalised smokers

INTRODUCTION AND AIMS Nicotine replacement therapy (NRT) is recommended as a smoking cessation aid for hospitalised smokers. We examined factors associated with NRT use during hospitalisation and after discharge, and NRT uptake when systematically offered free of cost. DESIGN AND METHODS A nested analysis was conducted using data from a clinical trial that evaluated the effectiveness of a pharmacist-led smoking cessation intervention in 600 hospitalised smokers. RESULTS NRT was used at least once by 285 (48%) participants during hospitalisation and by 287 (48%) participants during the 12 months post-discharge. Heavy smokers and those who expressed interest in using NRT for their next quit attempt at baseline interview were more likely to use NRT during hospitalisation [odds ratio (OR) 1.94, 95% confidence interval (CI) 1.38, 2.74; OR 2.09, 95% CI 1.48, 2.95] and after discharge (OR 1.70, 95% CI 1.20, 2.41; OR 1.97, 95% CI 1.39, 2.79). Those using six or more medications were more likely to use NRT during hospitalisation (OR 1.65, 95% CI 1.05, 2.61). Post-discharge NRT users were more likely to have been initially admitted for a respiratory or cardiac problem (OR 1.51, 95% CI 1.05, 2.18). When NRT was offered free of cost to a subset of patients (n = 300), 157 (52%) used NRT during hospitalisation. Nicotine dependence and interest in using NRT predicted its use (OR 2.26, 95% CI 1.38, 3.70; OR 2.58, 95% CI 1.58, 4.20). DISCUSSION AND CONCLUSIONS Targeting heavy smokers, those with cardio-respiratory conditions and those interested in using NRT regardless of regimen complexity could improve NRT uptake.

[1]  B. Bonevski,et al.  Integrating smoking cessation into routine care in hospitals--a randomized controlled trial. , 2016, Addiction.

[2]  B. Bonevski,et al.  Quitting experiences and preferences for a future quit attempt: a study among inpatient smokers , 2015, BMJ Open.

[3]  Shannon M Carlin-Menter,et al.  Nicotine replacement therapy distribution to light daily smokers calling a quitline. , 2013, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[4]  B. Bonevski,et al.  A pharmacist-led system-change smoking cessation intervention for smokers admitted to Australian public hospitals (GIVE UP FOR GOOD): study protocol for a randomised controlled trial , 2013, Trials.

[5]  M. Munafo,et al.  Interventions for smoking cessation in hospitalised patients. , 2012, The Cochrane database of systematic reviews.

[6]  A. Hyland,et al.  The reliability and predictive validity of the Heaviness of Smoking Index and its two components: findings from the International Tobacco Control Four Country study. , 2010, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[7]  S. Shiffman,et al.  Perceived safety and efficacy of nicotine replacement therapies among US smokers and ex-smokers: relationship with use and compliance. , 2008, Addiction.

[8]  J. Hanlon,et al.  Polypharmacy in elderly patients. , 2007, The American journal of geriatric pharmacotherapy.

[9]  S. Shiffman,et al.  Characteristics of selectors of nicotine replacement therapy , 2005, Tobacco Control.

[10]  S. Shiffman Nicotine lozenge efficacy in light smokers. , 2005, Drug and alcohol dependence.

[11]  J. Gitchell,et al.  Nicotine Replacement Therapy Use Among a Cohort of Smokers , 2005, Journal of addictive diseases.

[12]  D. Singer,et al.  The use of nicotine-replacement therapy by hospitalized smokers. , 1999, American journal of preventive medicine.

[13]  S. Rollnick,et al.  Helping smokers make decisions: the enhancement of brief intervention for general medical practice. , 1997, Patient education and counseling.

[14]  D. Mant,et al.  Nicotine replacement therapy for smoking cessation. , 2008, The Cochrane database of systematic reviews.

[15]  J. Vessey,et al.  Predictors of quitting in hospitalized smokers. , 2003, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[16]  K. Emmons,et al.  The use of nicotine replacement therapy during hospitalization , 2000, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.