Effectiveness of nicotine replacement therapy on smoking cessation among pulmonary tuberculosis patients of Mangaluru, India: A randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Keyword(s):  
Smoking Cessation ◽  
Pulmonary Tuberculosis ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Smoking Status ◽  
Controlled Trial ◽  
Control Group ◽  
Nicotine Replacement ◽  
Tuberculosis Patients ◽  
Brief Advice

UNSTRUCTURED Tuberculosis and tobacco smoking are two largely preventable public health concerns that independently pose a considerable threat to global health. The current estimates put the annual global mortality from the two epidemics at over six million. It is remarkable to note that TB and tobacco use are co-prevalent in many developing nations and these are said to be overburdened by the collision of the two epidemics. This study aims to determine the effectiveness of nicotine replacement therapy on smoking cessation among the pulmonary tuberculosis patients undergoing Directly Observed Therapy- Short Course. This is a randomized, placebo-controlled, two-arm, single blinded trial being conducted in Mangaluru, India. The total sample size including both the arms is 300. This study will be conducted between January 2019 and August 2020. Extra-pulmonary TB, smokeless tobacco users, patients with contraindications for NRT such as recent MI, angina pregnancy & lactation will be excluded from the study.Block Randomization will be done to obtain the two groups using a permuted The experimental group will be given nicotine replacement therapy and brief advice and the control group will be given brief advice and sugar-free chewing gum as a placebo for 3 months on a tapering dosage basis. The smoking status of the patients will be confirmed by urine cotinine test at the baseline and endline. Carbon monoxide monitoring and Fagerstom score will be recorded on a monthly basis.The participants will be followed for another 3 months to obtain a binary variable of smoking cessation status as "Quitter" or Non-quitter". The study also determines the TB outcome between tobacco quitters and non-quitters. Ethical clearance is obtained from the Institutional Ethics Committee of Nitte (deemed to be University) and the trial is registered with Clinical Trials Registry of India.

scholarly journals Assessing the delivery of smoking cessation interventions in adult inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S311-S311
Author(s):  
Katie Blissard Barnes ◽  
Richard Westmoreland
Keyword(s):  
Smoking Cessation ◽  
Physical Health ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Smoking Status ◽  
Service Users ◽  
Nicotine Replacement ◽  
Adult Inpatient ◽  
The Uk ◽  
Brief Advice

AimsTo assess level of compliance with national and local guidance with regards to the recording of service users smoking status and offering of interventions.BackgroundAcross the general population, prevalence of smoking is decreasing but in those with severe mental illness, the prevalence hasn't significantly changed. LYPFT are working towards becoming a smoke-free trust. The Trust Guidance expects that Trusts should ask 100% of service users if they smoke (which should be recorded on their physical health CQUIN) and of those that do, should be offered nicotine replacement therapy and cessation advice. Public Health England is working towards all hospital trusts across the UK being Smoke-free.MethodAll service users on each of the 4 adult inpatient wards at the Becklin Centre, Leeds, were included in the audit. A total of 78 service users were included in the audit.We reviewed the digital records for every service user, specifically looking at the physical health CQUIN. We recorded if smoking status had been documented and what interventions (if any) had been recorded as given. Possible interventions included offering brief advice and offering Nicotine replacement therapy. We then reviewed medication charts to see if any nicotine replacement therapy had been prescribed.ResultThe audit found that approximately half of all service users in our audit smoked cigarettes and that the vast majority of these had their smoking status documented in their digital medical records.Three quarters of those that smoked were offered brief cessation advice and half of them were offered Nicotine Replacement Therapy. Only a third of service users that smoked had NRT prescribed on their medication chart. This represented 65% of those recorded as being offered NRT.ConclusionThere are numerous possible reasons for the above outcomes. These include a lack of knowledge and confidence in delivering smoking cessation interventions, conversations having taken place but not recorded and confusion regarding the appropriate staff member to deliver the intervention. In addition, whilst only medical professionals typically prescribe NRT, the physical health CQUIN is recorded by nurses. Therefore, this may reflect a lack of communication between staff groups.Our trust will become smoke free in the near future. To facilitate this, we hope to reduce the discrepancy between the number of service users who smoke and the number prescribed NRT.

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.

scholarly journals A Randomized Controlled Trial of Two Different Lengths of Nicotine Replacement Therapy for Smoking Cessation

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Abu S. Abdullah ◽  
Anthony J. Hedley ◽  
Sophia S. C. Chan ◽  
Tai-Hing Lam
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Controlled Trial ◽  
Point Prevalence ◽  
Nicotine Replacement ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Quit Rate

This study examined if 2-week free nicotine replacement therapy (NRT) would be more effective than 1-week free NRT to help smokers quit smoking at 6 and 12 months. In a single-blinded randomized controlled trial design, 562 Chinese smokers who attended a smoking cessation clinic in Hong Kong, China, were randomly allocated into two groups (A1 and A2): A1 (n=284) received behavioural counselling with free NRT for 1 week; A2 (n=278) received similar counselling with free NRT for 2 weeks. All subjects received printed self-help materials to support their quitting efforts. A structured questionnaire was used for data collection, including pattern of NRT use and self-reported 7-day point prevalence quit rate at 6 months and 12 months. Among the participants, the mean number of cigarettes smoked per day was 18.8 (SD=10.9). By intention-to-treat analysis, 7-day point prevalence quit rates were not significantly different between A1 and A2 groups at 6-month (27.5% versus 27.3%;P=0.97) and 12-month (21.1% versus 21.2%;P=0.98) followup. The findings suggest that two-week free NRT was not more effective than 1-week free NRT to increase smoking cessation rate among Chinese smokers.

scholarly journals A Controlled Trial of Naltrexone Augmentation of Nicotine Replacement Therapy for Smoking Cessation

2006 ◽  
Vol 166 (6) ◽  
pp. 667 ◽  
Author(s):  
Stephanie S. O’Malley ◽  
Judith L. Cooney ◽  
Suchitra Krishnan-Sarin ◽  
Joel A. Dubin ◽  
Sherry A. McKee ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Controlled Trial ◽  
Nicotine Replacement
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