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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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.
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.
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.
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.
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.