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Transdermal Nicotine Patches With Low-Intensity Support to Aid Smoking Cessation in Outpatients in a General HospitalA Placebo-Controlled Trial
Jonathan Foulds, MAppSci;
John Stapleton, MSc;
Mary Hayward;
Michael A. H. Russell, FRCP;
Colin Feyerabend, PhD;
Tracey Fleming;
John Costello, MD, FRCP
Arch Fam Med. 1993;2(4):417-423.
Abstract
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Objective
To assess whether transdermal nicotine patches combined with low-intensity support can help outpatients in a general hospital stop smoking.
Design
Randomized, double-blind, placebo-controlled trial with 12 weeks of follow-up.
Setting
Department of Thoracic Medicine in an innercity public general hospital, London, England.
Subjects
Two hundred forty-eight outpatients in a general hospital, who smoked at least 10 cigarettes per day (the majority were being treated for smoking-related diseases), referred by clinicians at the hospital.
Intervention
Brief advice to stop smoking and daily application of transdermal nicotine patches (delivering 15 mg over 16 hours) or placebo, with follow-up appointments at 1, 3, 6, and 12 weeks, with a doubling of the dosage for continuing smokers at week 1.
Main Outcome Measure
Sustained abstinence from tobacco from week 3 to week 12 validated with measurement of expired-air carbon monoxide concentration at weeks 3, 6, and 12.
Results
Twenty-nine (23.4%) of 124 subjects assigned to the nicotine group were validated as having abstained from smoking at both weeks 3 and 6, compared with 16 (12.9%) of 124 subjects receiving placebo (P=.008). At week 12, 22 (17.7%) of the subjects in the nicotine group were validated as having abstained at all three points as were 15 (12.1%) of the subjects in the placebo group (P=.058).
Conclusion
Transdermal nicotine patches combined with low-intensity support are effective in helping outpatients in a general hospital stop smoking but do not prevent relapse after 6 weeks.
Author Affiliations
From the Health Behaviour Unit, Institute of Psychiatry, National Addiction Centre, London, England (Messrs Foulds and Stapleton, Ms Hayward, and Dr Russell); Poisons Unit, New Cross Hospital, London (Dr Feyerabend); and the Department of Thoracic Medicine, Kings College Hospital, London (Ms Fleming and Dr Costello).
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