Biomedical subjects

Fiona Gillison

Publications and source records attributed to Fiona Gillison.

3 recordsLinked to original sources

PubMed2007

Dependence potential of nicotine replacement treatments: effects of product type, patient characteristics, and cost to user.

OBJECTIVE: To assess the extent of long-term use of different nicotine replacement treatment products in smokers attending routine smoking cessation treatment and to examine the effect of nicotine replacement treatment cost on its long-term use. METHOD: 1518 consecutive patients prescribed nicotine replacement treatment at the East London Smokers' Clinic between January 2000 and November 2002 were followed up at 1-year. RESULTS: The rates of long-term use ranged from 2% for patch to 13% for nasal spray. Long-term use of nicotine replacement treatment was significantly more likely in more dependent smokers. Treatment cost, and whether it was provided free of charge, had no significant effect on its long-term use. CONCLUSIONS: Long-term use of nicotine replacement treatment is not uncommon. Its occurrence seems positively related to speed of nicotine delivery of individual products. For self-selected highly dependent smokers, long-term use of nicotine replacement treatment may be a necessary precondition for maintaining long-term abstinence. The findings have financial and clinical implications for providers of smoking cessation services.

Administration, Cutaneous↗

PubMed2004

The relationship between smoking cessation and mouth ulcers.

Patients who stop smoking often complain of aphthous (mouth) ulcers. This symptom is sometimes attributed to the use of smoking cessation medications, but little is known about it. We investigated the incidence, severity, and time course of mouth ulcers in abstaining smokers and the effect of different smoking cessation medications on the symptom. The sample consisted of 1234 smokers who sought treatment at a large smoking cessation clinic, maintained at least 1 week of continuous biochemically validated abstinence, and provided usable data. Participants assessed their mouth ulcers by rating a mouth ulcer item added to the Mood and Physical Symptoms Scale. Subjects made ratings weekly on three occasions while still smoking and over 4 weeks following smoking cessation. After stopping smoking, some 40% of patients developed mouth ulcers, mostly in the first 2 weeks. The problem was generally mild, but 8% reported severe ulceration. The ulcers resolved within 4 weeks in 60% of patients affected. The ulcer ratings in patients using oral nicotine replacement products were higher than in those using patch, nasal spray or bupropion in the first week of abstinence but not afterward. Mouth ulcers were more prevalent in more dependent smokers, and the occurrence of ulcers correlated with other tobacco withdrawal symptoms. Our results confirm that mouth ulcers are a common result of stopping smoking, affecting two in five quitters. Patients should be reassured that the lesions are a result of stopping smoking and not a side-effect of smoking cessation medication.

Adult↗

PubMed2003

Stopping smoking can cause constipation.

SETTING: Constipation is mentioned occasionally as a possible tobacco withdrawal symptom, but no systematic data have been published on this issue. DESIGN: Smokers' clinic patients provided ratings of their level of constipation on three occasions prior to their quit date, and then weekly after they stopped smoking. The total of 1067 participants maintained at least 1 week of continuous abstinence and provided usable data. FINDINGS: The three precessation ratings of constipation were stable. After cessation of smoking, the ratings increased significantly (P < 0.01). In 514 patients who maintained continuous abstinence for 4 weeks and provided complete data, constipation peaked at 2 weeks but remained elevated over the whole period. The net proportion of patients affected was 17%, including 9% who were symptom-free at baseline and became very or extremely constipated. In patients on nicotine replacement the increase in constipation, although significant, was less than in patients on bupropion. CONCLUSIONS: Clinicians treating smokers need to be aware of a possibility that one in six quitters develop constipation, and that for about one in 11 the problem can be severe. Descriptions of tobacco withdrawal syndrome should include constipation.

Bupropion↗