Authors (including presenting author) :
Wong MK(1), Lai SK(1), Wong CKC(1), Cheng SYR(1), Chu TK(1), Liang J(1)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, NTWC
Introduction :
Smoking poses a significant risk on health. Patients with chronic diseases are especially at risk. Even tobacco smoking is itself a form of chronic disease. Since 1980s, nicotine replacement therapy (NRT) has become widely used for smoking cessation. However, some smokers reject gum due to the difficulty in “park-and-chew”. Nicotine lozenge was first introduced to our Smoking Cessation Counselling Center (SCCC) since 2016. Lozenges might be also better than a patch if patients have a history of skin irritation to adhesive. Different NRTs have been shown to increase smoking cessation rates but locally no published trials have directly compared between them.
Objectives :
To compare the effectiveness of nicotine lozenge versus gum, patch and combination therapy for smoking cessation at 1, 6 and 12 month among smokers with moderate to high nicotine dependence having chronic diseases namely hypertension, diabetes mellitus, asthma, chronic obstructive pulmonary disease, ischaemic heart disease, and cerebral vascular accident.
Methodology :
242 smokers (89% male, 11% female), aged 29 to 90 (mean age 59) having chronic diseases attended SCCC from 1/10/2016 to 30/9/2017 were reviewed. Counselling and close follow-up were provided by trained nurses or occupational therapist. The clinical data were retrieved and analysed. Moderate to high nicotine dependence refers to smokers with ≥10 cigarettes/day and Fagerstrom score ≥4.
Result & Outcome :
The 7-days point abstinence rates for nicotine lozenge at 1, 6 and 12 months were 37.5%, 37.8% and 43.2% while for those who had received nicotine gum were 22.2%, 24% and 30.4%. Besides, the 7-days point abstinence rates for nicotine patch at 1, 6 and 12 months were 41.1%, 36.7% and 42.2% while for those who had received combination therapy were 44.4%, 32.6% and 35.7%. Abstinence rates were higher in those who received nicotine lozenge than gum at all time points and were comparable to patch or combination therapy (Table 2 & 3). Among the elderly, a higher proportion of them chose nicotine lozenge (Table 1). Compared between two acute forms, the mean age of patients using lozenge (62.73) was significantly greater than that of gum (57.74) (P=0.025) (Table 4). Conclusion The nicotine lozenge is effective for smoking cessation in moderate to high dependence smokers and especially popular among the elderly. This further improves chronic disease management.
Co-location with:
