Management of Acute Nicotine Withdrawal What is Nicotine Withdrawal Impact of Nicotine Withdrawal in hospital settings Hide exacerbate symptoms Diagnostically confusing Impact pain management ID: 1047230
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1. Joanna FeeneyClinical Delivery Manager – Tobacco Management of Acute Nicotine Withdrawal
2. What is Nicotine Withdrawal?
3. Impact of Nicotine Withdrawal in hospital settings?Hide / exacerbate symptomsDiagnostically confusingImpact pain managementIncreased risk of infection FiresViolence against staffUndermines Smokefree NHS policy
4. Clinical Responsibility to treat nicotine withdrawal Duty of care to treat acute nicotine withdrawalResponsibility is not solely the inhouse Tobacco Dependency AdvisorTreatment within 2 hours of admission
5. How Nicotine Dependency worksNicotine from smokingNicotine level during abstinenceNicotine from Nicotine Replacement
6. Provision of NRT in hospital settingsPrescribedPrescribers onlyDelays if prescribers not on wardPatient Group DirectiveAllows product to be issued without being prescribedRestricted to registered Health professionals (TDA’s not able to use)Specialist Pharmacy Service do not recommend PGD for GSL productsLocal ProtocolAny trained staff can initiate, both admitting staff & TDAEnables timely access to medicationPotential to include vapes
7. Enablers to Managing Nicotine withdrawal
8. Myths about NicotineOver 40% of smokers believe that the harm from smoking comes from nicotine11% of smokers believe that NRT is equal or more harmful than cigarettes43% of adults believe e-cigs are equally or more harmful than cigarettesHowever there is no evidence of long term harm from nicotine use:“Lifetime use is likely to be considerably less harmful than smoking” NICE
9. SummaryAcute management of Nicotine withdrawal is a clinical responsibilityIt is unethical to allow patients in enforced abstinence to suffer withdrawal Treating & managing nicotine withdrawal supports Smokefree policyTreatment of nicotine withdrawal should:be offered to all smokers, regardless of intention to quitEasily accessible in a timely manner, ideally within 2hrs