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Smokers with serious mental illness and requests for nicotine replacement therapy post-hospitalisation
  1. Rachel K Schuck1,
  2. Audun Dahl2,
  3. Sharon M Hall3,
  4. Kevin Delucchi3,
  5. Sebastien C Fromont3,
  6. Stephen E Hall3,
  7. Thomas Bonas4,
  8. Judith J Prochaska1,3
  1. 1Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA
  2. 2Department of Psychology, University of California, Santa Cruz, Santa Cruz, California, USA
  3. 3Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
  4. 4Alta Bates Summit Medical Center, Herrick Hospital, Berkeley, California, USA
  1. Correspondence to Dr Judith J Prochaska, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA 94305-5411, USA; JPro{at}Stanford.edu

Abstract

Background and aims Smoke-free psychiatric hospitalisation provides opportunity for initiating tobacco cessation treatment. The current study reports on psychiatric patients’ interest in continuing nicotine replacement therapy (NRT) posthospitalisation and examines patient predictors of NRT requests, quit attempts and abstinence at 1-week follow-up.

Methods Daily smokers were recruited and interviewed on locked psychiatric units at three smoke-free San Francisco Bay Area hospitals. Intent to quit smoking was not required to participate and 73% of eligible smokers enrolled. Analyses focused on 816 participants (49% female) randomised to interventions providing counselling tailored to readiness to quit with availability of NRT posthospitalisation. Logistic regressions tested demographic, smoking and psychiatric factors predictive of NRT requests, quit attempts and abstinence 1-week postdischarge.

Results Participants averaged 17 (SD=10) cigarettes/day for an average of 19 (SD=14) years. Most (88%) requested study-provided NRT (74% right at discharge). Participants preparing to quit and those with more severe psychiatric symptoms were more likely to request NRT at discharge (p<0.01). Those with more severe psychiatric symptoms also were more likely to request NRT refill, as were older participants (p<0.05). Participants who requested NRT at discharge were more likely to make a 24 h quit attempt and self-report abstinence at the 1-week follow-up (54% quit attempt, 14% abstinent) than participants who did not (25% quit attempt, 4% abstinent) (p<0.05).

Conclusions The great demand for NRT and the association between NRT use with quit attempts and abstinence at 1-week posthospitalisation supports adoption of tobacco treatment in acute psychiatric settings.

Trial registration number # NCT00968513.

  • Nicotine
  • Cessation
  • Priority/special populations
  • Addiction

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