Treating Tobacco Dependence in Inpatient Psychiatry - 1
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation, Tobacco Consumers |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | July 2006 |
| End Date: | April 2011 |
Treating Tobacco Dependence in Inpatient Psychiatry
The purpose of this study is to test in a randomized clinical trial (N=300) a series of
hypotheses concerning the efficacy of an extended expert-system intervention plus nicotine
replacement therapy (NRT) for treating tobacco dependence among patients hospitalized on a
smoke-free psychiatric unit. It is hypothesized that the intervention will be more effective
than the enhanced standard care control condition (on-unit NRT with self-help brochure) in
producing biochemically verified abstinence from cigarettes at 3-, 6-, 12-, and 18-months
follow up. Additionally, intervention participants will exhibit greater stage progression,
commitment to abstinence, and delay in relapse to smoking following hospital discharge,
factors predictive of future success with quitting smoking. Smoking cessation treatments
have been shown to be highly cost-effective with the general population of smokers, and cost
is likely to be a consideration in efforts to incorporate additional services into an
inpatient psychiatric setting. Therefore, a secondary specific aim is to model the
cost-effectiveness of the smoking cessation intervention. Intervention efficacy will be
examined in a university-based psychiatric inpatient unit. A smaller pilot study (N=48) will
examine translation of the intervention to a county hospital serving a more diversified
patient population.
hypotheses concerning the efficacy of an extended expert-system intervention plus nicotine
replacement therapy (NRT) for treating tobacco dependence among patients hospitalized on a
smoke-free psychiatric unit. It is hypothesized that the intervention will be more effective
than the enhanced standard care control condition (on-unit NRT with self-help brochure) in
producing biochemically verified abstinence from cigarettes at 3-, 6-, 12-, and 18-months
follow up. Additionally, intervention participants will exhibit greater stage progression,
commitment to abstinence, and delay in relapse to smoking following hospital discharge,
factors predictive of future success with quitting smoking. Smoking cessation treatments
have been shown to be highly cost-effective with the general population of smokers, and cost
is likely to be a consideration in efforts to incorporate additional services into an
inpatient psychiatric setting. Therefore, a secondary specific aim is to model the
cost-effectiveness of the smoking cessation intervention. Intervention efficacy will be
examined in a university-based psychiatric inpatient unit. A smaller pilot study (N=48) will
examine translation of the intervention to a county hospital serving a more diversified
patient population.
Inclusion Criteria:
Men and women over 18 years of age hospitalized on an inpatient psychiatric unit who
report smoking at least 5 cigarettes per day. Other inclusion criteria include: smoking at
least 100 cigarettes in one's lifetime, residing in the San Francisco Bay Area with no
plan to relocate outside of the area in the next 18 months, and access to a telephone for
scheduling follow up assessments.
Exclusion Criteria:
Dementia or other brain injury precluding ability to participate; non-English speaking;
severe agitation, psychosis, or hostility; and medical contraindications to nicotine
replacement therapy (NRT). Recruitment of acutely psychotic, manic, or hostile patients
will be delayed until there is significant reduction of these symptoms. Medical
contraindications are: myocardial infarction in the preceding 3 months, unstable angina
pectoris, liver or kidney disease, current pregnancy or breast feeding, allergies to
adhesives, or other medical conditions that the medical team deems incompatible with NRT
use.
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San Francisco General Hospital San Francisco General Hospital and Trauma Center (SFGH) is an essential...
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