scholarly journals Varenicline is More Effective than Nicotine Replacement Therapy During Pregnancy: Findings from the Smoking MUMS (Maternal Use of Medications and Safety) Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Stephanie KY Choi ◽  
Duong T Tran ◽  
David B Preen ◽  
Deborah Randall ◽  
Anna Kemp-Casey ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Statistical Power ◽  
Propensity Scores ◽  
Healthcare Providers ◽  
Nicotine Replacement ◽  
Quit Smoking ◽  
South Wales ◽  
Expected Benefits

IntroductionStudies in the general population suggest that varenicline is more effective than nicotine replacement therapy (NRT) for smoking cessation. However, clinical guidelines recommend against the use of varenicline during pregnancy and suggest NRT be used when the expected benefits outweigh the potential risks. Objectives and ApproachWe evaluated whether varenicline was more effective than NRT for smoking cessation when used during pregnancy. Routinely-collected records of all births (01/01/2011-12/31/2012) in New South Wales and Western Australia were used to identify a cohort of women who smoked during the first 20 weeks of pregnancy. Pharmaceutical dispensing data were then linked to identify varenicline or NRT dispensing in the first 20 weeks of pregnancy. Smoking cessation was defined as women reported not smoking after the first 20 weeks of pregnancy. Inverse probability of treatment weighting with propensity scores were used to account for differences between the two treatment groups. ResultsOverall, 117 women used varenicline and 135 NRT in the first 20 weeks of pregnancy. In the unweighted sample, more women who used varenicline quit smoking after the first 20 weeks than women using NRT (28.2% vs. 11.1%, crude rate difference:17.1%, 95% confidence intervals[CI]:7.4-26.8%). In the weighted sample, quitting rate was 12.7% (95%CI:0.8-24.6%) higher in pregnant smokers who used varenicline (27.4% vs. 14.7%) when compared to those who used NRT. Conclusion/ImplicationsPregnant smokers using varenicline were more likely to quit smoking than those using NRT. This information will assist healthcare providers to make informed recommendations, but data regarding safety of varenicline in pregnancy are also urgently needed. Future studies with greater statistical power are required to confirm our results.

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.

Is Stress Management Training a Useful Addition to Physician Advice and Nicotine Replacement Therapy during Smoking Cessation in Women? Results of a Randomized Trial

2005 ◽  
Vol 20 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Monika E. Slovinec D'Angelo ◽  
Robert D. Reid ◽  
Stephen Hotz ◽  
Jane Irvine ◽  
Roanne J. Segal ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Confidence Interval ◽  
Stress Management ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Perceived Stress ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Nicotine Replacement ◽  
Quit Smoking

Purpose. To determine whether a stress management (SM) program could improve cessation rates when added to usual care (UC) among women attempting to quit smoking. Design. Randomized controlled trial conducted during a 12-month period. Setting. Smoking cessation clinics located within two tertiary care centers in Ottawa, Ontario. Subjects. A total of 332 women smokers 19 years or older who smoked 10 or more cigarettes per day were recruited via advertisements. Intervention. Either UC (physician advice and nicotine replacement therapy) or UC plus an eight-session group SM training program (coping skills development relevant to smoking-specific and generic stressors). Measures. Point prevalence abstinence 2 and 12 months after study intake. A secondary outcome of interest was change in perceived stress during the intervention period. Results. On an intent-to-treat basis, the addition of SM to UC had no incremental effect on 2-or 12-month abstinence rates. Abstinence rates at 2 months were 26.2% vs. 31.7% in the UC and SM groups, respectively (p = .59). At 12 months, the rates were 18.5% vs. 20.7% (p = .86). When quit rates were compared including only participants who demonstrated adequate adherence to the intervention protocol, there was a significant difference between the UC and SM groups at 2 months (34.9% vs. 48.7%; adjusted odds ratio, 1.88; 95% confidence interval, 1.04–3.42; p = .04) but not at 12 months (23.0% vs. 28.2%; adjusted odds ratio, 1.24; 95% confidence interval, .64–2.41; p = .53). There was a significant reduction in perceived stress from preintervention to postintervention; however, this decrease was not moderated by group assignment. Conclusion. The addition of SM in our setting neither increased abstinence rates nor reduced perceived stress over and above UC in women motivated to quit smoking. Poor attendance at the SM intervention undermined its effectiveness.

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 Development of a Mobile Health Intervention with Personal Experiments for Smokers Who Are Ambivalent About Quitting: Formative Design and Testing (Preprint)

2020 ◽  
Author(s):  
Jaimee L Heffner ◽  
Sheryl L Catz ◽  
Predrag Klasnja ◽  
Brooks Tiffany ◽  
Jennifer B McClure
Keyword(s):  
Pilot Study ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Mobile Health ◽  
Smoking Behavior ◽  
Nicotine Replacement ◽  
Counseling Intervention ◽  
The Core ◽  
Core Content ◽  
Quit Smoking

BACKGROUND The majority of cigarette smokers want to quit someday but are not ready to commit to long-term abstinence. However, available smoking cessation treatments are not well-suited to meet the needs of these ambivalent smokers. Low-cost, high-reach mobile health (mHealth) interventions may be a cost-efficient means of offering assistance to ambivalent smokers, yet there are currently no evidence-based options available for this group. OBJECTIVE The aim of this study was to develop and preliminarily evaluate the core content for an mHealth program targeting adult smokers who are ambivalent about quitting. The core content consisted of a series of “personal experiments” similar to those tested as part of a counseling intervention in prior work, including brief cognitive or behavioral tasks designed to boost readiness for changing smoking behavior. METHODS We conducted individual user interviews (N=3) to refine program content, and then conducted a one-arm pilot study (N=25) to assess user receptivity and the potential impact of the experiments on motivation and self-efficacy to quit or reduce smoking. RESULTS In user interviews, participants liked the concept of the personal experiments. Participants in the pilot study found a medium-fidelity prototype to be highly acceptable. After watching a brief orientation video that explained how the program works, most participants (80%, 20/25) indicated that it sounded interesting, primarily because it did not require any commitment to quit. All participants (100%, 25/25) completed all 7 experiments, including a 24-hour quit attempt, although not all were able to refrain from smoking for a full day based on qualitative feedback on the experiment. The mean rating of usefulness of the overall program was 4.12 (SD 1.09) out of 5, and the average rating of the difficulty of the experiments was 2.16 (SD 1.18) out of 5. At the last assessment point, 92% (23/25) of the participants indicated that they were more interested in either quitting or cutting back than when they began the program, and 72% (18/25) said that if the program had included a free trial of nicotine replacement therapy, they would have used it to try to quit smoking. CONCLUSIONS This formative work confirmed that ambivalent smokers are willing to use and will remain engaged with an mHealth intervention that employs the novel concept of personal experiments to enhance their motivation for and ability to quit smoking. The addition of action-oriented treatment (self-help and free nicotine replacement therapy, quitline referral) could further support users’ efforts to stop smoking and remain quit.

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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