Perceived safety and efficacy of nicotine replacement therapies among US smokers and ex‐smokers: relationship with use and compliance

Shiffman, Saul; Ferguson, Stuart G.; Rohay, Jeffrey M.; Gitchell, Joseph G.

doi:10.1111/j.1360-0443.2008.02268.x

Cited by 134 publications

(130 citation statements)

References 22 publications

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“…36 The reasons that underlie the variations in the use of medications for tobacco cessation for patients who are older with more comorbidities are unclear, but may reflect safety concerns and fatalism on the part of patients and physicians. Though multiple studies have indicated that these therapies are safe to use in patients with a variety of medical conditions, 37,38 many patients have erroneous beliefs that nicotine replacement is dangerous or ineffective, 39,40 and these beliefs may be more common among patients who are older and sicker. Physicians and patients who are faced with continued tobacco use by a patient of advanced age or with significant medical comorbidity may feel fatalistic about the success and benefits of quitting.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

et al. 2016

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BACKGROUND: Many smokers admitted for chronic obstructive pulmonary disease (COPD) are not given smoking cessation medications at discharge. The reasons behind this are unclear, and may reflect an interplay of patient characteristics, health disparities, and the receipt of inpatient tobacco control processes. OBJECTIVES: We aimed to assess potential disparities in treatment for tobacco use following discharge for COPD, examined in the context of inpatient tobacco control processes. PARTICIPANTS: Smokers aged ≥ 40 years, admitted for treatment of a COPD exacerbation within the VA Veterans Integrated Service Network 20, identified using ICD-9 discharge codes and admission diagnoses from 2005-2012. MAIN MEASURES: The outcome was any tobacco cessation medication dispensed within 48 hours of discharge. We assessed potential predictors administratively up to 1 year prior to admission. We created the final logistic regression model using manual model building, clustered by site. Variables with p < 0.2 in biviariate models were considered for inclusion in the final model. RESULTS: We identified 1511 subjects. 16.9 % were dispensed a medication at discharge. In the adjusted model, several predictors were associated with decreased odds of receiving medications: older age (OR per year older 0.96, 95 % CI 0.95-0.98), black race (OR 0.34, 95 % CI 0.12-0.97), higher comorbidity score (OR 0.89, 95 % CI 0.82-0.96), history of psychosis (OR 0.40, 95 % CI 0.31-0.52), hypertension (OR 0.75, 95 % CI 0.62-0.90), and treatment with steroids in the past year (OR 0.80, 95 % CI 0.70-0.90). Inpatient tobacco control processes were associated with increased odds of receiving medications: documented brief counseling at discharge (OR 3.08, 95 % CI 2.02-4.68) and receipt of smoking cessation medications while inpatient (OR 5.95,. CONCLUSIONS: Few patients were treated with tobacco cessation medications at discharge. We found evidence for disparities in treatment, but also potentially beneficial effects of inpatient tobacco control measures. Further focus should be on using novel processes of care to improve provision of medications and decrease the observed disparities.

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Section: Discussionmentioning

confidence: 99%

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

et al. 2016

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“…Consecuentemente, sus hallazgos generan inquietud frente a la variabilidad en la población incluida en los ensayos clínicos, en donde la presencia de fumadores crónicos o con alta dependencia no ha sido suficientemente clara. Además, se ha revisado el escaso cumplimiento de las indicaciones terapéuticas, que sugieren el uso de reemplazo nicotínico por, al menos, seis semanas y la percepción equivocada sobre la magnitud del efecto para este tratamiento que lleva a desestimular a muchos de los fumadores por no encontrar alivio en corto tiempo o en la intensidad esperada (48)(49)(50).…”

Section: Discussionunclassified

Recomendaciones para la cesación de la adicción al tabaco en Colombia: guía de práctica clínica basada en la evidencia

et al. 2012

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: escritura del protocolo de investigación, documento de alcance y objetivos, búsqueda de la literatura. Juan Sebastián Castillo: orientación metodológica en la aplicación de la metodología ADAPTE y búsqueda de la literatura. Luz Helena Alba y Raúl Murillo: escritura del presente artículo. Todos los autores calificaron la 'evidencia', realizaron la extracción de datos e intervinieron en diferentes fases del proceso de adaptación de la guía nacional, y revisaron el manuscrito. ARTÍCULO ORIGINAL Biomédica 2013;33:186-204 doi: http://dx.doi.org/10.7705/biomedica.v33i2.651 Recomendaciones para la cesación de la adicción al tabaco en Colombia Introducción. El tabaquismo es el principal factor de riesgo para enfermedades crónicas que constituyen la mayor carga en Colombia. Objetivos. Generar recomendaciones de práctica clínica sobre eficacia y seguridad del tratamiento para la cesación de la adicción al tabaco en adultos colombianos. Materiales y métodos. Se hizo una adaptación basada en la metodología ADAPTE. Se buscaron guías de práctica clínica en Medline, EMBASE, CINAHL, LILACS y Cochrane. Se evaluó la cesación a seis meses para consejería breve e intensiva, terapia de reemplazo nicotínico, bupropión, vareniclina, clonidina, nortriptilina, acupuntura, hipnosis, homeopatía y la combinación de tratamientos. Se utilizó el German Instrument for Methodological Guideline Appraisal (DELBI) para evaluar las guías de práctica clínica. Se seleccionaron las guías con puntaje mayor de 60 % en rigor metodológico y aplicabilidad en Colombia. Las preguntas sin evidencia fuerte se llevaron a consenso. Resultados. Se encontraron 925 referencias, se preseleccionaron 17 guías de práctica clínica y se escogieron 5 para adaptación. La consejería breve e intensiva, la terapia de reemplazo nicotínico, el bupropión, la nortriptilina y la vareniclina son eficaces en la cesación de tabaquismo (incrementó 5,1 % a 22,7 %). Los tratamientos alternativos no tienen eficacia demostrada en la cesación. El uso simultáneo de diferentes formas de terapia de reemplazo nicotínico es la única combinación con eficacia demostrada (OR 1,9; IC 95% : 1,3-2,7). Conclusiones. Existen diversas alternativas con eficacia demostrada para dejar de fumar. Los incrementos en las tasas de cesación son variables y la duración del efecto necesita mayor seguimiento. Para aplicar la consejería breve e intensiva en Colombia, se deben usar formatos estándar. Se requieren evaluaciones económicas para valorar el impacto y seleccionar las mejores intervenciones en el contexto colombiano.Palabras clave: tabaco, tabaquismo, nicotina, cese del tabaquismo, cese del uso de tabaco, guías de práctica clínica como asunto doi: http://dx.doi.org/10.7705/biomedica.v33i2.651 Recommendations for smoking cessation in ColombiaIntroduction: Chronic diseases represent the greatest burden of disease in Colombia for which smoking is the major risk factor. Objectives: To provide clinical practice recommendations based upon efficacy and safety of smoking cessation therapies for Colombian ad...

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“…At some point, the clinician advises the patient to quit and asks if she is willing to make a quit attempt. By now, she may well be in nicotine withdrawal because it has been hours since she last smoked; she still feels ill from the complaint that prompted the visit; and she knows little about what tobacco treatments are available [4], their efficacy [5] or what course of action her clinician thinks would be best for her.…”

Section: Response To Commentaries: Changing the Treatment Default Wilmentioning

confidence: 99%

Response to commentaries: changing the treatment default will improve decision-making

Richter

Ellerbeck

2015

Addiction

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Perceived safety and efficacy of nicotine replacement therapies among US smokers and ex‐smokers: relationship with use and compliance

Cited by 134 publications

References 22 publications

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

Recomendaciones para la cesación de la adicción al tabaco en Colombia: guía de práctica clínica basada en la evidencia

Response to commentaries: changing the treatment default will improve decision-making

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