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Published Online: 1 November 2013

Clinical Management of Tobacco Dependence in Inpatient Psychiatry: Provider Practices and Patient Utilization

Teresa M. Leyro, Ph.D., Sharon M. Hall, Ph.D., Norval Hickman, Ph.D., M.P.H., Romina Kim, B.S., Stephen E. Hall, M.D., and Judith J. Prochaska, Ph.D., M.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 64, Number 11
https://doi.org/10.1176/appi.ps.201200574
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Abstract

Objective

This investigation examined predictors of utilization of nicotine replacement therapy (NRT) during a smoke-free psychiatric hospitalization.

Methods

Smokers (N=324) were recruited from smoke-free adult inpatient psychiatric units. Exploratory analyses examined correlates of NRT provision and utilization.

Results

The prevalence of NRT use was 51% overall and was greater among patients offered NRT on admission (58%) versus later (34%), among patients with more severe depression and nicotine withdrawal, and among those who reported perceptions that NRT decreases nicotine withdrawal, provides a nicotine substitute, and helps with quitting smoking (p<.05, all comparisons). Although the ratio of nicotine patch dose to usual cigarettes per day was 1.2±.7, the ratio was negatively correlated with time to first cigarette (Spearman’s ρ=–.30, p<.01), suggesting potential underdosing of more dependent smokers.

Conclusions

During smoke-free psychiatric hospitalizations, clinical management of nicotine withdrawal may be enhanced by offering patients NRT directly on admission, educating patients on the benefits of NRT, and increasing the dosage for more dependent smokers.

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Information & Authors

Information

Published In

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Cover: Paul Cadmus, by Luigi Lucioni, 1928. Oil on canvas, 16 × 12⅛ inches. Brooklyn Museum, Dick S. Ramsay Fund, 2007.28.

Psychiatric Services
Volume 64 • Number 11 • November 2013
Pages: 1161 - 1165
PubMed: 24185538

History

Published online: 1 November 2013
Published in print: November 2013

Authors

Details

Teresa M. Leyro, Ph.D.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Sharon M. Hall, Ph.D.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Norval Hickman, Ph.D., M.P.H.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Romina Kim, B.S.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Stephen E. Hall, M.D.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Judith J. Prochaska, Ph.D., M.P.H.
Dr. Leyro, Dr. Sharon Hall, and Dr. Stephen Hall are with the Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143 (e-mail: [email protected]). Dr. Hickman is with the State of California Tobacco-Related Disease Research Program, University of California Office of the President, Oakland. Ms. Kim is with the College of Human Medicine, Michigan State University, East Lansing. Dr. Prochaska is with the Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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