23rd February 2018, Volume 131 Number 1470

Penelope Truman, Moira Gilmour, Geoffrey Robinson

Smoking tobacco is an addiction which, for some, is very difficult to give up, even during hospital admissions.1,2 In New Zealand and in many other countries smoking is banned within…

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Summary

Alcoholics who were also smokers, admitted to Kenepuru Hospital for detoxification, were offered the option of using an electronic cigarette as well as, or instead of, conventional nicotine replacement therapy nicotine (patches or gum) to help them to stop smoking while in hospital. The electronic cigarettes proved more popular that standard nicotine replacement therapy and were at least as effective. Using electronic cigarettes for smoking substitution/reduction while in hospital is an option for improved patient management that should be explored further.

Abstract

Aim

A feasibility/acceptability trial was undertaken at Ward 5, Kenepuru Hospital, Porirua, to ascertain whether electronic cigarettes (e-cigarettes) were a useful option to replace or reduce smoking in the detoxification ward.

Method

Two groups of patients were studied. Tobacco use and dependency data were collected for each. The first group was surveyed on the usefulness of standard nicotine replacement therapy (NRT). The second group were offered e-cigarettes with the option of standard NRT as well. All were asked to record their use of cigarettes, e-cigarettes and NRT during their stay on the ward, and to comment on their experiences. Outcomes monitored were self-reported use of NRT and of tobacco. Informal impressions of the nursing staff were also collected, where offered. For the e-cigarette group, a blood sample was taken on day 3 or 4 of their stay in hospital for nicotine/cotinine analysis, to confirm nicotine intake status.

Results

E-cigarettes were well tolerated as a form of nicotine replacement, eliciting positive comments, though they were not effective for all. The average reduction in median cigarettes per day was very similar between the group given standard NRT and the e-cigarette group, at 80% and 86% respectively. There were no adverse effects reported.

Conclusion

The study showed that e-cigarettes were an acceptable form of nicotine replacement for these alcohol-dependent patients during their time in the ward. For heavily tobacco-dependent smokers, e-cigarettes may provide a useful aid to patient management within a hospital setting.

Author Information

Penelope Truman, Senior Scientist, Environmental Health, Institute of Environmental Science and Research Ltd, Porirua; Senior Lecturer, School of Public Health, Massey University, Wellington;
Moira Gilmour, Clinical Nurse Specialist, Capital and Coast District Health Board, Wellington;
Geoffrey Robinson, Physician, Capital and Coast District Health Board, Wellington; Medical Research Institute of New Zealand, Wellington.

Acknowledgements

We thank the staff of Ward 5, Kenepuru Hospital for their interest and cooperation, and Canterbury Health Laboratories for their analytical work. 
Funding for this project was provided by the New Zealand Tobacco Control Research Tūranga (Emerging Issues Fund): The Tūranga is supported through funding from the Reducing Tobacco-related Harm Research Partnership, co-funded by the Health Research Council of New Zealand and the Ministry of Health of New Zealand (HRC grant 11/818).

Correspondence

Dr Penelope Truman, Massey University, School of Health Sciences, PO Box 756, Wellington 6140.

Correspondence Email

p.truman@massey.ac.nz

Competing Interests

Dr Truman reports grants from New Zealand Tobacco Control Research Tūranga (Emerging Issues Fund): The Tūranga is supported through funding from the Reducing Tobacco-related Harm Research Partnership, co-funded by the Health Research Council of New Zealand and the Ministry of Health of New Zealand (HRC grant 11/818), during the conduct of the study; grants from New Zealand Tobacco Control Research Tūranga (Emerging Issues Fund), personal fees from California Department of Public Health, outside the submitted work; and Dr Truman is a member of End Smoking New Zealand, a charitable organisation which advocates for harm reduction.

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