Efficacy Of Nicotine Replacement Therapy (NRT) To Aid Cigare ✓ Solved

Efficacy of Nicotine Replacement Therapy (NRT) to Aid Cigarette

Tobacco smoking is a major contributor to many serious diseases that eventually lead to death in the United Kingdom (UK). According to the Office of National Statistics (ONS) (2017), 7.4 million of the United Kingdom’s population are smokers, and 19.7 percent of these smokers are adults aged 25 to 34 years. Tobacco cigarettes contain nicotine, which alters the balance of two chemicals, norepinephrine and dopamine, in the human brain. The sudden change in these chemicals after inhalation may result in mood changes that could reduce stress and anxiety while increasing feelings of pleasure (National Health Service (NHS), 2018a). The rapid delivery of nicotine into the bloodstream via smoking may lead to significant addiction, disregarding its adverse effects on health.

Stopping smoking is a monumental challenge for many. According to the Health and Social Care Information Centre (HSCIC) (2017), 146,234 people attempted to quit smoking in 2017, but only 49 percent were successful in maintaining their abstinence. Among these, 33 percent employed licensed nicotine-containing products to assist their cessation efforts. In response to the significant public health issue that smoking poses, the UK government implemented a tobacco control plan aiming to deter smoking by increasing taxes on tobacco products, controlling tobacco advertising, raising public awareness of smoking harms, and decreasing exposure to second-hand smoke (Public Health England, 2015).

In the UK, the National Health Service (NHS) offers various smoking cessation services and interventions. According to the National Institute for Health and Care Excellence (NICE) (2019), several evidence-based interventions are available for adult smoking cessation, including behavioral support, bupropion, nicotine replacement therapy (NRT), varenicline, and very brief advice (VBA). These interventions can be used individually or in combination, depending on the individual’s needs and circumstances, to enhance the probability of successful quitting. This paper will explore various types of NRT available to adults in the United Kingdom and analyze their effectiveness.

NRT includes several modalities designed to mitigate withdrawal symptoms and cravings for cigarettes, ultimately facilitating a gradual reduction and cessation of smoking. The formulations available in the UK consist of gum, inhalers, lozenges, nasal sprays, oral sprays, sublingual tablets, and transdermal patches, as documented by NICE (2019b) and the National Centre for Smoking Cessation and Training (NCSCT) (2019).

A review of seven primary research articles will critically assess the effectiveness of NRT and propose alternative smoking cessation methods in the conclusion. The rationale for this exploration stems from my observations as a student nurse, where I noted that many hospitalized patients continued smoking, despite being aware of its detrimental health effects. Smokefree (2019) reports that smoking adversely affects nearly every organ in the human body, leading to significant health risks. Nicotine's detrimental impact extends to the brain, skin, heart, lungs, stomach, muscles, bones, blood, and immune system. Strengthening smoking cessation campaigns within clinical and community settings is imperative to address this pervasive issue.

The objective of this paper is to evaluate the efficacy of NRT specifically for adults in the UK, exploring the range of available NRT options that contribute to smoking cessation success. Wakefield (2015) emphasizes that research questions must be well-defined to avoid disorganized searches and irrelevant data.

The methodology employed in this paper involved an electronic search of databases such as CINAHL, British Nursing Database, Cochrane Library, BMC Nursing, and MEDLINE. The search was confined to primary research articles published between January 2008 and January 2019. Boolean operators were utilized, with keywords including NRT, smoking cessation, and the United Kingdom to refine the search results. Additionally, randomized controlled trials were prioritized through the application of limiters and expanders (see Appendix 2). The reference lists of relevant literature were also scrutinized for additional insights.

Conducting a thorough literature review is vital for providing evidence-based information. As noted by Smith and Noble (2016), the process must be systematic, incorporating clear inclusion and exclusion criteria to maintain the integrity of the research. The search yielded six primary research studies focused on the efficacy of NRT interventions for smoking cessation in the UK. Each paper underwent a rigorous credibility assessment and critique using Caldwell’s framework for health research (see Appendix 3).

The literature review underscored the challenges presented by secondary or non-evidence-based studies, which were omitted to ensure quality. It is crucial to utilize appropriate keywords, filters, and limiters to assemble relevant and substantial academic resources that address research queries effectively. The findings and analyses of the NRT studies will contribute significantly to the future of smoking cessation strategies and the role health professionals can play in assisting individuals to quit smoking.

Findings from Recent Research on NRT

Research indicates that NRT can significantly enhance cessation success rates among smokers. Aveyard et al. (2008) demonstrated that participants utilizing a combination of bupropion and nicotine replacement therapies had improved short-term abstinence compared to those relying solely on placebos. Moreover, Beard et al. (2011) highlighted that NRT use during enforced nicotine abstinence periods facilitated smoother transitions back to non-smoking status among users.

Klonizakis et al. (2017) explored the cardiovascular impacts of smokers utilizing e-cigarettes or NRT, finding that nicotine delivery via these alternatives may mitigate some health risks associated with conventional smoking. Lindson-Hawley et al. (2014, 2016) investigated the effectiveness of nicotine patch preloading prior to quit attempts, underscoring the necessity of informed planning in achieving sustained smoking cessation.

Overall, this literature emphasizes the necessity of employing comprehensive smoking cessation support that incorporates NRT, behavioral therapies, and proactive healthcare professional involvement. Tackling the smoking epidemic requires coordinated efforts between public health policy, clinical practice, and community engagement.

References

  • Action on Smoking and Health (ASH) (2019) Fact sheets: Smoking statistics. Available at: [insert link] (Accessed: 14/02/2019).
  • Aveyard, P., Johnson, C., Parsons, A., and Murphy, M. (2008) ‘Nortriptyline plus nicotine replacement versus placebo plus nicotine replacement for smoking cessation: pragmatic randomised controlled trial’, British Medical Journal: Online First, pp. 1-10.
  • Beard, E., McNeill, A., Aveyard, P. et al (2011) ‘Use of nicotine replacement therapy for smoking reduction and during enforced temporary abstinence: a national survey of English smokers’, Addiction, 106.
  • Caldwell, K., Henshaw, L. and Taylor, G. (2005) ‘Developing a framework for critiquing health research’, Journal of Health, Social and Environmental Issues, 6(1), pp. 45-54.
  • Cronin, P., Ryan, F. and Coughlan M. (2008) ‘Undertaking a literature review: a step-by-step approach’, British Journal of Nursing, 17(1), pp. 38-43.
  • National Centre for Smoking Cessation and Training (NCSCT) (2019) Stop smoking medication. Available at: [insert link] (Accessed: 15/02/2019).
  • National Institute for Health and Care Excellence (NICE) (2019) ‘Stop smoking interventions and services: NICE guideline [NG92].’ Available at: [insert link] (Accessed: 15/02/2019).
  • Public Health England (2015) Health Matters: smoking and quitting in England. Available at: [insert link] (Accessed: 15/02/2019).
  • Smokefree (2019) Health Effects. Available at: [insert link] (Accessed: 15/02/2019).
  • Wakefield, A. (2015) ‘Synthesising the literature as part of a literature review’, Nursing Standard, 29(29), pp. 44-51.

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