Treatments for Nicotine Addiction - Nicotine Replacement Flashcards
What is nicotine replacement therapy (NRT)?
A medically approved way to take nicotine by means other than tobacco
Can be prescribed by a doctor or bought over the counter
Where is NRT available?
Available free on the NHS or at the cost of a prescription (£9.15) which is a third cheaper than if the products were bought in a pharmacy
What is the aim of NRT?
Aims to stop or reduce the physical symptoms of nicotine withdrawal (such as cravings) and gradually reduce the number of nicotine receptors a smoker has
Who is NRT most beneficial for?
Most beneficial for heavy smokers who smoke more than 15 cigarettes per day
What are the different types of NRT?
Types of NRT include:
- adhesive patch
- chewing gum
- lozenges
- nose and mouth spray
What differences between the different types of NRT?
Provide different ways in which nicotine is delivered to the body
How long it takes for the nicotine to enter the body
Total time nicotine stays in the body
How do nicotine patches work?
Nicotine patches are applied to the skin and continuously administer a stable dose of nicotine slowly over 16-24 hours
Why do smokers combine the patch with other NRT products?
Nicotine gum, sprays and lozenges administer nicotine orally with quicker nicotine reuptake into the body but lasting a shorter amount of time
Useful as they deal with cravings quickly
What is the most effective way of using NRT?
Combing the use of patches and sprays with counselling or support from a doctor, nurse, pharmacist or stop smoking clinic
Eclectic approach - NRT deals with physical symptoms and counselling helps with psychological withdrawal symptoms
How long should NRT be used for?
Should be used for at least 8-12 weeks for the best chance of stopping smoking in the long term
Gives the brain time to reduce the number of nicotine receptors
Dose is usually reduced in the later part of the course and then stopped
What is the supporting evidence/strengths of NRT as a treatment for nicotine addiction?
NHS studies
Zhang (2015)
Stead (2012)
Psychology in society
What is the refuting evidence/weaknesses of NRT as a treatment for nicotine addiction?
Kotz (2014)
Side effects
Doesn’t address cause of addiction
Ethical issues
Social control
Why is NHS studies supporting evidence of NRT as a treatment for nicotine addiction?
NHS studies show NRT does increase the change of quitting smoking
Studies compared NRT to a similar placebo product in people who were keen to stop smoking
Results showed that, on average, about 17 in 100 people who took NRT stopped smoking successfully
Why is Zhang (2015) supporting evidence of NRT as a treatment for nicotine addiction?
Zhang used data from a longitudinal study of 3,968 smokers in Ontario to show that NRT did help when stopping smoking but was only effective if used for 8-12 weeks as recommended
Why is Stead (2012) supporting evidence of NRT as a treatment for nicotine addiction?
Stead also found evidence for the benefits of NRT suggesting it increased the rate of quitting by 60%
Was particularly true when two forms of NRT were combined such as patch and spray
Why is psychology in society a strength of NRT as a treatment for nicotine addiction?
Understanding how NRT can help smokers quit is a good example of psychology in society
Employers that hire smokers bear indirect costs, including employee absenteeism etc.
Furthermore, a study found that people who were exposed to smoke in the workplace were 17% more likely to develop lung cancer than those not exposed
Therefore, it’s in the companies best interests to tackle smoking in the workplace
Why is Kotz (2014) refuting evidence of NRT as a treatment for nicotine addiction?
Kotz in a cohort study of 1560 UK smokers found that NRT bought over the counter was associated with lower rates of abstinence after 6 months compared to a combined treatment of prescribed medication and behavioural support
Why is side effects a weakness of NRT as a treatment for nicotine addiction?
Side effects associated with using NRT may affect the compliance rate in patients who find that costs of the treatment outweigh its benefits
e.g. when using patches the patient may experience skin irritation
In addition to this more general side effects include insomnia, dizziness and headaches
Why is that fact it doesn’t address the causes of addiction a weakness of NRT as a treatment for nicotine addiction?
NRT alone doesn’t address the causes of addiction and is therefore prone to have high rates of relapse over time
e.g. if the addiction is caused by personal or social issues these may still be there and the individual may not have learned coping skills to deal with these
Why is ethical issues a weakness of NRT as a treatment for nicotine addiction?
A choice has to be made by the NHS as to whether preventative measures such as NRT are worth spending money on in the hope they may reduce future cases of smoking-related illnesses which cost the NHS millions each year
Some individuals object to NRT being available free on the NHS or at the cost of a prescription as smoking is a choice and therefore smokers should choose to stop to improve their health
Why is social control a weakness of NRT as a treatment for nicotine addiction?
The world’s most medication dependent cessation program is UK NHS Stop Smoking Services
The programs main aim is to use an advisor to tell smokers about nicotine replacement products and other stop smoking medicines
A review of this program suggests that medication use is all but forced upon participants. Some people see this as a lack of choice and that trained professionals are using their authority to force patients to use NRT
