Transdermal nicotine replacement for hospitalized patients: a randomized clinical trial.
BACKGROUND
This study was undertaken to assess the safety and efficacy of a treatment involving brief counseling and the nicotine patch among hospital inpatients and to identify variables associated with long-term smoking cessation following hospitalization.


METHODS
One hundred eighty-five patients were randomly assigned to one of three smoking cessation interventions: (1) A Minimal Care (MC) condition, consisting of a brief physician-delivered motivational message to stop smoking, (2) a Counseling + Active Nicotine Patch (CAP) condition in which patients received the motivational message, a 6-week supply of nicotine patches, and extended bedside and telephone counseling, and (3) a Counseling + Placebo Patch (CPP) condition identical to the CAP condition except the supplied patches contained no nicotine.


RESULTS
At 6-month follow-up, abstinence rates for the three treatments were 4.9, 6.5, and 9.7% for the MC, CPP, and CAP treatments, respectively. These differences were not statistically significant. Patients admitted for respiratory disease were more likely to quit than patients with any other diagnosis. The nicotine patch was well tolerated by hospital inpatients.


CONCLUSIONS
The initiation of nicotine patch therapy during hospitalization appears to be safe when used among patients carrying a wide range of diagnoses. Our study provided no evidence of the superiority of nicotine patches versus placebo, but this does not preclude the possibility that future research using larger samples might detect differences between patch groups. Hospital interventions for smoking cessation may be most effective among patients hospitalized for a smoking-related illness such as respiratory disease.
Lewis
S F
SF
Center for Tobacco Research and Intervention, University of Wisconsin at Madison 53706, USA.
Piasecki
T M
TM
Fiore
M C
MC
Anderson
J E
JE
Baker
T B
TB
D000279:Administration, Cutaneous; D000328:Adult; D003131:Combined Modality Therapy; D003376:Counseling; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008173:Lung Diseases, Obstructive / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009538:Nicotine / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D016540:Smoking Cessation / Q000523:psychology*
D009538:Nicotine