Nicotine Replacement Therapy

1998 ◽  
Vol 32 (10) ◽  
pp. 1067-1075 ◽  
Author(s):  
Gwendolyn H Thompson ◽  
Dee A Hunter
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Dependence ◽  
Drug Dependence ◽  
Behavioral Treatment ◽  
Treatment Plan ◽  
Withdrawal Symptoms ◽  
Self Administration ◽  
Nicotine Replacement

OBJECTIVE: To review the literature on nicotine dependence, nicotine pharmacology, health consequences associated with the use of nicotine, and nicotine replacement therapies used to aid smokers who are nicotine dependent. DATA SOURCES: A review of articles, book bibliographies, and published studies identified by a search of the MEDLINE database from 1982 to 1996 on nicotine dependence, nicotine addiction, nicotine withdrawal, smoking, smoking cessation, smoking intervention, nicotine pharmacology, nicotine pharmacokinetics, nicotine pharmacodynamics, and nicotine replacement therapies. STUDY SELECTION AND DATA EXTRACTION: Inclusion criteria were published randomized, double-blind trials of at least 12 weeks' duration, meta-analyses, and panel consensus guidelines. DATA SYNTHESIS: Cigarette smoking and tobacco use have met the surgeon general's primary criteria as well as additional criteria for drug dependence. Drug dependence requires that the drug produce psychoactive effects. Nicotine has been identified as the cause of tobacco dependence. First, nicotine provides positive reinforcement by stimulating nicotinic receptors to promote high self-administration rates. Second, nicotine causes a negative reinforcement in the form of withdrawal symptoms when nicotine is withheld after chronic use. Nicotine replacement therapy reduces the severity of withdrawal symptoms in smokers abstaining from tobacco. Nicotine replacement therapy allows the smoker to focus on psychosocial aspects of tobacco abstinence while receiving relief from withdrawal symptoms. The long-term effectiveness and health benefits of nicotine replacement therapy coupled with nonpharmacologic approaches have been clearly established. Smoking cessation has received wide attention from the public and medical communities; it is complex and has several interwoven factors to be considered. The psychological, behavioral, and physical components have to be understood before designing a treatment plan. The most successful approaches to smoking cessation involve multicomponent, multisession behavioral treatment programs as a foundation coupled with pharmacologic intervention. Pharmacists can play a key role in initiating behavior change and ensuring the safe and proper use of nicotine replacement in order to produce the desired outcome. CONCLUSIONS: The optimum choice in nicotine replacement depends on the individual's needs and coping abilities. Individualized nicotine replacement coupled with nonpharmacologic interventions produces the highest rate of success for abstinence from nicotine.

scholarly journals Acute Exercise Effects on Craving and Withdrawal Symptoms among Women Attempting to Quit Smoking Using Nicotine Replacement Therapy

2012 ◽  
Vol 7 (2) ◽  
pp. 72-79 ◽  
Author(s):  
Therese Harper ◽  
Lyndsay Fitzgeorge ◽  
Amelia Tritter ◽  
Harry Prapavessis
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Acute Exercise ◽  
Physical Symptoms ◽  
Withdrawal Symptoms ◽  
Moderate Intensity ◽  
Exercise Session ◽  
Nicotine Replacement ◽  
Quit Smoking

Background: Cigarette cravings are one of the most often expressed difficulties related to quitting. The effect of acute exercise on craving and withdrawal symptoms during a pharmacological based smoking cessation intervention is unknown. Methods: Participants included female smokers (n = 178) undertaking the Getting Physical on Cigarettes trial — a 14-week exercise-aided nicotine replacement therapy (NRT, i.e. patch) cessation program. They completed the Shiffman-Jarvik scale immediately before and after the first scheduled exercise session during weeks 5, 11, and 13. The first exercise session (week 5) occurred shortly after participants quit smoking (week 4) and began their 21 mg NRT patch dose. The second and third exercise bout coincided soon after participants stepped down their NRT strength to 14 mg (week 11) and 7 mg (week 13), respectively. Results: Significant reductions in cigarette craving were demonstrated following exercise at all three time points (i.e. week 5, 11, and 13). Significant reductions in psychological and sedation withdrawal symptoms were shown at week 5 and 11, but not at week 13. Significant increases in physical symptoms were found at week 5 and 11, but not week 13. No significant change in appetite was evident at any time point. Conclusions: An acute bout of moderate intensity exercise can alleviate cravings as well as psychological and sedation withdrawal symptoms in quitters during a 14-week exercise-aided NRT smoking cessation program. Promoting exercise among women using NRT is recommended.

scholarly journals QuitNic: A Pilot Randomized Controlled Trial Comparing Nicotine Vaping Products With Nicotine Replacement Therapy for Smoking Cessation Following Residential Detoxification

2020 ◽  
Author(s):  
Billie Bonevski ◽  
Victoria Manning ◽  
Olivia Wynne ◽  
Coral Gartner ◽  
Ron Borland ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Withdrawal Symptoms ◽  
Nicotine Replacement ◽  
Behavioral Counseling ◽  
Randomized Controlled

Abstract Introduction The QuitNic pilot trial aimed to test the feasibility of providing a nicotine vaping product (NVP) compared with combination nicotine replacement therapy (NRT) to smokers upon discharge from a smoke-free residential substance use disorder (SUD) treatment service. Methods QuitNic was a pragmatic two-arm randomized controlled trial. At discharge from residential withdrawal, 100 clients received telephone Quitline behavioral support and either 12-week supply of NRT or an NVP. Treatment adherence and acceptability, self-reported abstinence, cigarettes smoked per day (CPD), frequency of cravings, and severity of withdrawal symptoms were assessed at 6 and 12 weeks. Results are reported for complete cases and for abstinence outcomes, penalized imputation results are reported where missing is assumed smoking. Results Retention on was 63% at 6 weeks and 50% at 12 weeks. At 12 weeks, 68% of the NRT group reported using combination NRT while 96% of the NVP group used the device. Acceptability ratings for the products were high in both groups. At 12 weeks, 14% of the NVP group and 18% of the NRT group reported not smoking at all in the last 7 days. Mean CPD among continued smokers decreased significantly between baseline to 12 weeks in both groups; from 19.91 to 4.72 for the NVP group (p < .001) and from 20.88 to 5.52 in the NRT group (p < .001). Cravings and withdrawal symptoms significantly decreased for both groups. Conclusions Clients completing residential withdrawal readily engaged with smoking cessation post-treatment when given the opportunity. Further research is required to identify the most effective treatments postwithdrawal for this population at elevated risk of tobacco-related harm. Trial registration number ACTRN12617000849392 Implications This pilot study showed that smoking cessation support involving options for nicotine replacement and Quitline-delivered cognitive behavioral counseling is attractive to people after they have been discharged from SUD treatment. Both nicotine vaping products and nicotine replacement therapies were highly acceptable and used by participants who reported reductions in cravings for cigarettes and perceptions of withdrawal symptoms and reductions in number of cigarettes smoked. Some participants self-reported abstinence from cigarettes—around one in five reported having quit smoking cigarettes at 12 weeks postdischarge. The results have significant public health implications for providing quit support following discharge from SUD treatment.

scholarly journals Efficacy of Vaping as a Nicotine Replacement Therapy for Smoking Cessation Among Adults: A Review of the Literature

2018 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Charl Woo
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Successful Treatment ◽  
Tobacco Cessation ◽  
Nicotine Addiction ◽  
Review Of The Literature ◽  
Nicotine Replacement ◽  
Extreme Hazards ◽  
Cold Turkey

Evidence shows that successful treatment of nicotine addiction improves mortality, despite age at cessation. The extreme hazards of smoking stress the importance of patient-physician discussion that is a significant factor in tobacco cessation. Discussion alone and other methods such as “cold turkey” have proven to have low efficacy at cessation which has led to the development nicotine replacement therapy to help augment cessation.

scholarly journals Audit of inpatient smoking cessation advice

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S92-S93
Author(s):  
Flensham Mohamed ◽  
Mohamed Bader
Keyword(s):  
Smoking Cessation ◽  
Risk Factor ◽  
Physical Health ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Smoking Status ◽  
Health Board ◽  
List Type ◽  
Nicotine Replacement ◽  
Smoking Cessation Advice

AimsAudit carried out to assess whether or not patients had been asked about their smoking status during admission onto an acute adult mental health ward, as well as if they had received any smoking cessation advice or offered nicotine replacement therapy.Background•Physical health outcomes in patients with serious mental illness (SMI) are consisitently worse than the general public This is due to multiple factors; adverse effects of medication (including metabolic syndromes with psychotropics) as well as poor lifestyle factors such as smoking status•Patients with an SMI are 3–6 times more likely to die due to coronary artery disease. 70% of patients in inpatient psychiatric units are smokers, a strong independent risk factor for cardiovascular disease.•Smoking cessation is a potent modifiable risk factor that can prevent mortality and reduce morbidity.MethodA cross-sectional review of all 34 inpatients across four general adult acute psychiatric wards.Patient records were explored using the Aneuran Bevan Health Board admission proformas to identify evidence of smoking status and whether advice was offered.ResultSmoker but not given cessation advice n = 13 (38%)Not asked about smoking n = 11 (32%)Smoker and given cessation advice n = 4 (12%)Non-smoker n = 6 (18%)ConclusionPatients were asked about their smoking status the majority of the time (68%) but provision of advice or nicotine replacement therapy was only done in 14% of potential smokers (identified smokers and patients not asked about smoking status).A consideration to be taken into account is that on admission, a patient's physical health status may be unknown, with the additional difficulty of a patient's acute distress complicating the physical examination, smoking status and modification of patient's smoking status may not be the highest priory in that context.Data regarding asking about smoking were different amongst wards, potentially signifying differences between assessors willingness to ask about smoking status.There is a lack of smoking cessation literature available on the wards and patients are often unaware of what options are available to quit smoking.The audit simply determined whether or not assessors were documenting smoking status, it does not measure the quantity or quality of smoking cessation advice provided.Further quality improvement projects should be launched, with focus groups as the intial step at further investigating inpatient smoking rates, as well as attempting to reduce them in a more systemic way.

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