Chronically ill who smoke need added help to quit
Individuals with serious illnesses, including cancer, heart disease, and chronic obstructive pulmonary disease, make up a disproportionately high segment of current smokers and are also among the most addicted to tobacco use. Despite their strong addiction, more than one-third of these individuals are likely to give up smoking and remain smoke-free for at least six months if they receive a combination of smoking cessation medications and are allowed to continue taking these medications for a longer period of time, researchers at the University of Medicine and Dentistry of New Jersey (UMDNJ) report.
In their study, the researchers randomly assigned 127 smokers with predefined medical conditions to one of two groups. The first group received nicotine patches for a standard 10-week treatment period. The second group received a combination of nicotine patches, nicotine inhalers, and bupropion, an antidepressant medication commonly prescribed for treating tobacco dependence. After 26 weeks, 35% of those who received the combination therapy had quit smoking, compared to just 19% of those who received the nicotine patch alone. The results of this study appear in the April 7 edition of Annals of Internal Medicine.
"Common sense would tell you to quit smoking if you have a serious disease, but more than half of smokers who are newly diagnosed with cancer continue to smoke," said study author Michael Steinberg, MD, MPH, assistant professor of general medicine at the of the University of Medicine and Dentistry of New Jersey (UMDNJ) -Robert Wood Johnson Medical School in New Brunswick and medical director of the Tobacco Dependence Program at the UMDNJ-School of Public Health in New Brunswick. "Our research illustrates how terribly addictive tobacco is, but that addiction can be overcome if treated appropriately."
Current product labeling discourages combining nicotine patches with other forms of nicotine replacement and strictly limits the recommended length of time these products should be used. At the same time, treatment for tobacco dependence is not usually reimbursed well by insurance companies. Both are mistakes, Steinberg contends.
"People with serious illnesses who smoke will live longer and have a better quality of life if they receive aggressive treatment for their tobacco dependence," Steinberg said. "Insurance companies will bristle at paying for six months of nicotine therapy, but will turn around and allow benefits for 50 years of prescription statin medications to control cholesterol. Tobacco dependence should be considered like any other chronic illness and, with the right amount of therapy, people can remain tobacco-free for good."
Individuals with serious illnesses, including cancer, heart disease, and chronic obstructive pulmonary disease, make up a disproportionately high segment of current smokers and are also among the most addicted to tobacco use.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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