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Smoking reduction and nicotine preloading: new approaches to cessation?

Lindson, Nicola (2012)
Ph.D. thesis, University of Birmingham.

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Abstract

The Department of Health aim to reduce smoking prevalence to 10% by 2020; however estimates suggest this shall not be achieved. One way to increase the decline may be to introduce new cessation interventions into NHS Stop Smoking Services. Literature reviews and meta-analyses were used to test the efficacy of smoking reduction and nicotine preloading in comparison to current NHS treatments (abrupt quitting and nicotine replacement therapy post-quit, respectively), in smokers who wanted to quit. Results of the two reviews suggest that both approaches produce similar quit rates to their comparators. We suggest that pre-quit reduction should be offered alongside abrupt quitting, to encourage more smokers to use cessation services. However the use of nicotine preloading would be premature, as evidence of benefit is inconclusive. The protocol for a randomised controlled non-inferiority trial using both approaches is presented. Trial participant interviews suggest that reduction methods are feasible and may have more enduring popularity than abrupt quitting, providing further support for this approach. Accounts also suggest potential mechanisms of preloading, although a literature review provided little evidence of these. Further research should establish the effect of preloading, its mechanisms of action, and the best way to advise smokers to reduce.

Type of Work:Ph.D. thesis.
Supervisor(s):Aveyard, Paul and West, Robert and Michie, Susan
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Health and Population Sciences, Department of Primary Care Clinical Sciences
Subjects:R Medicine (General)
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
ID Code:3245
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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