Factors associated with nicotine replacement therapy use among hospitalised smokers

Chui, Chang Yue; Thomas, Dennis; Taylor, Simone E; Bonevski, Billie; Abramson, Michael J.; Paul, Eldho; Poole, Susan; Weeks, Gregory; Dooley, Michael; George, Johnson

doi:10.1111/dar.12661

Cited by 6 publications

(9 citation statements)

References 18 publications

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“…Since NRT is the preferred choice of cessation medication of many smokers 24 , 25 , our findings suggest that the provision of free NRT is acceptable to adult smokers in the emergency setting. Research in the adult in-patient setting has found that the provision of free NRT results in increased rates of subsequent use during hospitalization and after discharge 26 , 27 . The high rate of NRT usage after the emergency visit reported in our study parallels these findings and is encouraging.…”

Section: Discussionmentioning

confidence: 99%

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Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting

Mahabee‐Gittens¹,

Merianos²,

Tabangin³

et al. 2020

Tob. Prev. Cessation

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INTRODUCTION Although the administration of free Nicotine Replacement Therapy (NRT) is effective in helping smokers quit, the feasibility, acceptability and safety of this practice have not been examined in the emergency setting of the pediatric emergency department (PED) or urgent care (UC). We examined the characteristics of parental smokers who were interested and eligible for free NRT during their child’s emergency visit and the uptake, usage, and associated side effects of NRT use. METHODS We analyzed data from 377 parental smokers who were randomized to receive cessation counseling and free NRT as part of an emergency visit-based randomized controlled trial. Parents interested in NRT were screened for medical contraindications; eligible parents were given a 6-week supply of NRT patches or lozenges during their child’s emergency visit and offered another supply 6 weeks later. We conducted Wilcoxon rank-sum tests and chi-squared tests to address our main study objective. RESULTS The majority of parents were female (87.5%), non-Hispanic Black (52.5%), and mean (SD) age was 33.1 (8.2) years. A total of 252 (66.8%) parents were interested in receiving NRT. Compared to uninterested parents, interested parents were more likely to: be older [33.6 (8.2) vs 31.9 (8.2), years]; be non-Hispanic Black (54.0% vs 49.6%); have older children [5.5 (5.0) vs 4.2 (4.6)]; have a higher readiness to quit [7.0 (2.4) vs 5.2 (2.6)]; and have a child being evaluated in UC compared to the PED (72.4% vs 56.5%). A total of 53 (21%) interested parents had >1 NRT contraindications. At 6 weeks, 94 (79.0%) parents reported some ≥NRT usage and 50 (53.2%) requested an additional 6-week supply. There were no serious adverse events and 5 (5.3%) reported minor side effects. CONCLUSIONS Parental smokers in the emergency setting are interested in receiving free NRT, the majority use it, and use is not associated with adverse side effects. The emergency visit may be an optimal time to offer NRT to parental smokers.

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Section: Discussionmentioning

confidence: 99%

“…Research in the adult in-patient setting has found that the provision of free NRT results in increased rates of subsequent use during hospitalization and after discharge 26,27 . The high rate of NRT usage after the emergency visit reported in our study parallels these findings and is encouraging.…”

Section: Discussionmentioning

confidence: 99%

Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting

Mahabee‐Gittens¹,

Merianos²,

Tabangin³

et al. 2020

Tob. Prev. Cessation

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“…Previous research has found that smoking cessation medication use prior to hospitalization [6, 8], nicotine dependence [6–8] and less confidence in ability to not smoke [8] are associated with medication use while hospitalized. Consistent with the present results, post-discharge medication use has been associated with inpatient medication use [5, 18], medication use prior to hospitalization [5], shorter length of stay [5] and tobacco related disease [6]. These results lend support to findings from the general population in which smokers who elected to use NRT were more nicotine dependent, less confident in their ability to quit and generally possessed more risk factors for cessation failure [19].…”

Section: Discussionmentioning

confidence: 99%

“…Regan et al, 2012 found that smokers who received NRT during hospitalization were more likely to use it after discharge compared with those who did not use NRT in hospital [5]. Chui et al, 2018 found that predictors of NRT use among hospitalized smokers during their hospital stay and at discharge included heavy smoking and expressing interest in NRT for their next quit attempt [6]. Smokers who were admitted for a respiratory or cardiac problem were more likely to use a cessation medication at discharge [6].…”

Section: Introductionmentioning

confidence: 99%

“…Chui et al, 2018 found that predictors of NRT use among hospitalized smokers during their hospital stay and at discharge included heavy smoking and expressing interest in NRT for their next quit attempt [6]. Smokers who were admitted for a respiratory or cardiac problem were more likely to use a cessation medication at discharge [6]. Although these previous studies show that patient characteristics are associated with smoking cessation pharmacotherapy use, the process of how patients do or do not receive pharmacotherapy in hospital and prescriptions on discharge is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Critical steps in the path to using cessation pharmacotherapy following hospital-initiated tobacco treatment

Liebmann

Scheuermann

Faseru

et al. 2019

BMC Health Serv Res

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Background Hospital-initiated smoking cessation interventions utilizing pharmacotherapy increase post-discharge quit rates. Use of smoking cessation medications following discharge may further increase quit rates. This study aims to identify individual, smoking-related and hospitalization-related predictors of engagement in three different steps in the smoking cessation pharmacotherapy utilization process: 1) receiving medications as inpatient, 2) being discharged with a prescription and 3) using medications at 1-month post-hospitalization, while accounting for associations between these steps. Methods Study data come from a clinical trial ( N = 1054) of hospitalized smokers interested in quitting who were randomized to recieve referral to a quitline via either warm handoff or fax. Variables were from the electronic health record, the state tobacco quitline, and participant self-report. Relationships among the predictors and the steps in cessation medication utilization were assessed using bivariate analyses and multivariable path analysis. Results Twenty-eight percent of patients reported using medication at 1-month post-discharge. Receipt of smoking cessation medications while hospitalized ( OR = 2.09, 95%CI [1.39, 3.15], p < .001) and discharge with a script ( OR = 4.88, 95%CI [3.34, 7.13], p < .001) were independently associated with medication use at 1-month post-hospitalization. The path analysis also revealed that the likelihood of being discharged with a script was strongly influenced by receipt of medication as an inpatient ( OR = 6.61, 95%CI [4.66, 9.38], p < .001). A number of other treatment- and individual-level factors were associated with medication use in the hospital, receipt of a script, and use post-discharge. Conclusions To encourage post-discharge smoking cessation medication use, concerted effort should be made to engage smokers in tobacco treatment while in hospital. The individual and hospital-level factors associated with each step in the medication utilization process provide good potential targets for future implementation research to optimize treatment delivery and outcomes. Trial registration Number: NCT01305928 . Date registered: February 24, 2011.

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Which hospitalized smokers receive a prescription for quit-smoking medication at discharge? A secondary analysis of a smoking cessation randomized clinical trial

Patel¹,

Richter²,

Mussulman³

et al. 2019

Journal of the American Pharmacists Association

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Factors associated with nicotine replacement therapy use among hospitalised smokers

Abstract: Targeting heavy smokers, those with cardio-respiratory conditions and those interested in using NRT regardless of regimen complexity could improve NRT uptake.

Cited by 6 publications

References 18 publications

Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting

Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting

Critical steps in the path to using cessation pharmacotherapy following hospital-initiated tobacco treatment

Which hospitalized smokers receive a prescription for quit-smoking medication at discharge? A secondary analysis of a smoking cessation randomized clinical trial

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