The work contained herein was conducted as part of a higher degree (J. Williams).
Craving control using nicotine replacement therapy in a teaching hospital
Article first published online: 18 MAR 2010
© 2010 The Authors. Journal compilation © 2010 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 3, pages 317–322, March 2012
How to Cite
Jones, T. E. and Williams, J. (2012), Craving control using nicotine replacement therapy in a teaching hospital. Internal Medicine Journal, 42: 317–322. doi: 10.1111/j.1445-5994.2010.02222.x
Funding: Nicorette inhalers and transdermal patches were provided by Pharmacia Australia. The manufacturers had no input into study design, data analysis or manuscript preparation.
Conflict of interest: None.
- Issue published online: 18 MAR 2010
- Article first published online: 18 MAR 2010
- Accepted manuscript online: 4 AUG 2010 12:16PM EST
- Received 3 November 2009; accepted 14 February 2010.
- nicotine administration and dosage;
- tobacco use disorder;
- organisational policy;
Background: A period of hospitalisation is perhaps the longest period of enforced ‘temporary abstinence’ smokers have to endure and hence many crave during their admission. Cravings may result in patients' smoking on hospital premises. Nicotine replacement may reduce cravings, decrease smoking on hospital grounds and increase interest in quitting post-discharge.
Aim: The aim of this study was to compare the efficacy of two nicotine formulations in controlling inpatient cravings and enthusiasm for quitting post-discharge.
Methods: Inpatients who were smokers were randomised to nicotine patch or inhaler on alternating days. Patients selected their preferred formulation, which was then used for the duration of the hospital stay. Craving control and formulation preference were assessed by visual analogue scales (VAS), and interest in quitting on a 3-point scale. Abstinence was confirmed by exhaled breath CO monitoring.
Results: Patches were preferred by 64% of the 367 subjects. Fewer patients went outside to smoke after either formulation (37% before, 5% after enrolment). Cravings were reduced by both nicotine formulations (mean VAS score fell from 7.5 to 1.7). Interest in quitting post-discharge increased. Estimated mean exposure to nicotine was 5 mg/day (inhaler), 15 mg/day (transdermal patch) compared with 30 mg/day (cigarettes) before hospitalisation.
Conclusions: Many smokers crave and some smoke outside during a hospital admission. While the patch was the preferred formulation of nicotine replacement therapy, both were effective in reducing cravings, increasing motivation for quitting post-discharge and improving Hospital ‘image’ by reducing smoking on campus. Nicotine replacement therapy should be made available to inpatients in all hospitals and other places of enforced prolonged abstinence.