546P Randomised controlled trial comparing nicotine replacement therapy (NRT) plus brief counselling and brief counselling alone on smoking cessation in patients prone to lung cancer using a breath carbon monoxide (CO) monitor

Abstract

Background Tobacco use in any modality is the greatest preventable morbidity and mortality in developing world. Cessation interventions require an equal balance of pharmacotherapy and behavioural supportive care. Studies of nicotine replacement therapy (NRT) in patients to date have been relatively small, and although suggestive of a beneficial effect, have not shown significant differences relative to placebo, results supported by a systematic review of the subject. We have therefore conducted a pragmatic open randomised controlled trial to determine whether a brief cessation counselling intervention suitable for widespread use, or the same counselling intervention given with NRT, is more effective than usual care in promoting smoking cessation. Methods Patients who were prone to lung cancer were randomised to receive either usual care (no additional advice at admission), counselling alone (20-minute intervention with written materials), or NRT plus counselling (counselling intervention with a 6 week course of NRT). Inclusion Criteria-Previous lung disease, a family history of lung cancer, Past cancer treatment, Lowered immunity, Previous smoking related cancers, Exposure to certain chemicals and radon gas. Continuous and point prevalence abstinence from smoking (validated by exhaled carbon monoxide <10 ppm) was measured at 3 and 12 months, and self-reported reduction in cigarette consumption in smokers was assessed at 3 and 12 months. Results 300 smokers were enrolled. Abstinence was higher in the NRT plus counselling group (n = 100) than in the counselling alone (n = 100) or usual care (n = 100) groups. The difference between the groups was significant for validated point prevalence abstinence at 3 months (65%,33%, 27% respectively, p = 0.045) and at 12 months (27%, 16%, 14%, p = 0.03). There was no significant difference between counselling alone and usual care, or in reduction in cigarette consumption between the treatment groups. Conclusions NRT given with brief counselling to patients prone to lung cancer is an effective routine smoking cessation intervention. Legal entity responsible for the study N/A Funding DM wayanad institute of Medical Science Disclosure All authors have declared no conflicts of interest.