Increasing the Use of Nicotine Replacement Therapy by a Simple Intervention: An Exploratory Trial

Abstract

This historical cohort study conducted in a University Hospital between and 2006 included 322 smokers willing to quit and assessed whether adding a teaching session on nicotine addiction to a smoking cessation program could increase the proportion of participants using pharmacotherapy. The control cohort received the standard course while two short talks were added to the course for a consecutive intervention cohort. These talks used the metaphor of a pizza delivery service to explain neural mechanisms underlying nicotine addiction. Medication use was significantly more common in the intervention than control cohort (82.1%% vs. 51.2%%; adjusted odds ratio 4.0; 2.34–6.83).

RÉSUMÉ

Augmenter l’utilisation de la pharmacothérapie par une simple intervention:une étude exploratoire.

L’étude effectuée entre et 2006 dans un C.H.U. (centre hospitalier universitaire) comprenait 322 fumeurs ayant l’intention de cesser de fumer. L’enjeu était de démontrer dans quelle mesure des renseignements supplémentaires sur l’addiction au tabac augmenteraient le nombre des participants utilisant la pharmacothérapie. Tandis que le groupe contrôle ne suivait que le cours standard, le groupe d’intervention devait participer à deux cours supplémentaires. Dans ces entretiens la métaphore du livreur de pizzas servait à expliquer les mécanismes neuraux qui sont à la base de l’addiction au tabac. L’emploi de médicaments était, de manière significative, plus fréquent dans le groupe d’intervention que dans le groupe contrôle (82.1%% vs. 51.2%%; odds ratio ajusté 4.0; 2.34–6.83).

RESUMEN

Aumento del grado de uso del tratamiento sustitutivo de la nicotina mediante una intervención sencilla. Un estudio exploratorio

En el estudio de cohorte retrospectivo realizado en el Hospital Universitario entre los años y 2006, participaron 322 fumadores que deseaban dejar el tabaco. Se quería determinar si el hecho de incluir en el programa de deshabituación una sesión informativa sobre la adición a la nicotina incrementaría la proporción de participantes que siguen el tratamiento medicamentoso. El grupo control participó en el curso normal, mientras que un inmediato grupo intervención asistió adicionalmente a dos breves conferencias. En estas conferencias se empleó la metáfora de un servicio de pizza a domicilio para explicar los mecanismos neuronales subyacentes a la adicción a la nicotina. El uso de la medicación fue significativamente más generalizado en el grupo intervención que en el grupo control (82,1%% vs. 51,2%%; cociente de posibilidades ajustado 4,0; 2,34–6,83)

Keywords :

• smoking cessation
• nicotine replacement therapy
• neurobiology
• addiction
• patient education

THE AUTHORS

Tobias Raupach, MD, MME, is running the smoking cessation clinic at Göttingen University Hospital. He also works as a senior house officer in the Department of Cardiology and Pneumology. He has conducted experimental research in chronic-obstructive pulmonary disease and is the principal investigator of a clinical trial on pharmacotherapy for smoking cessation. Current research projects include a nation-wide survey among medical students addressing knowledge and competence regarding the management of smoking patients.

Lion Shahab, PhD, is currently working as a postdoctoral research associate at the Cancer Research UK Health Behaviour Research Centre at University College London. His expertise lies in epidemiology, tobacco control, public health, and health psychology. Current research interests focus on the detection of smoking-related diseases in the population, the use of smoking-related biomarkers to motivate smoking cessation, the development and impact of potential harm reduction strategies, and public attitudes to tobacco policy.

Stefanie Eimer is completing her doctoral dissertation in Pneumology at Göttingen University Hospital. She is currently working as a Junior House Officer at St. Johann Nepomuk Hospital, Erfurt, Germany.

Miriam Puls, MD, is a postdoctoral fellow at Göttingen University Hospital, Department of Cardiology and Pneumology. Her current research is focused on vascular biology, particularly atherosclerosis. Recent projects have investigated the influence of smoking and smoking cessation on biomarkers of elevated cardiovascular risk and on endothelial progenitor cells.

Gerd Hasenfuss, MD, is chief of the Department of Cardiology and Pneumology and chair of the Heart Center at Göttingen University. His main research interests are molecular pathophysiology and the treatment of heart failure including cardiac stem cell biology.

Stefan Andreas, MD, is head of a hospital specialized in pulmonary medicine (Lungenfachklinik Immenhausen) and is also affiliated with the Department of Cardiology and Pneumology at University Hospital Göttingen. His research interest encompasses cardiopulmonary interaction as reflected in smoking cessation, sleep disordered breathing, COPD, and lung cancer. He is secretary of the working group ‘Tobacco Prevention’ of the German Respiratory Society.