A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia

Joshua Trigg; Jane Rich; Edwina Williams; Amanda Baker; Linda Bauld; Ron Borland; Chris Bullen; Mark Daglish; Adrian Dunlop; Coral Gartner; David Jacka; Dan Lubman; Victoria Manning; Rose McCrohan; Cathy Segan; Natalie Walker; Billie Bonevski

doi:10.1111/dar.13850

A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia

Drug Alcohol Rev. 2024 Apr 23. doi: 10.1111/dar.13850. Online ahead of print.

Authors

Joshua Trigg¹, Jane Rich², Edwina Williams², Amanda Baker³, Linda Bauld⁴, Ron Borland⁵, Chris Bullen⁶, Mark Daglish⁷, Adrian Dunlop^{2

8}, Coral Gartner⁹, David Jacka¹⁰, Dan Lubman^{11

12}, Victoria Manning¹², Rose McCrohan¹³, Cathy Segan¹⁴, Natalie Walker⁶, Billie Bonevski^{1

2}

Affiliations

¹ Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
² School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia.
³ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
⁴ Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom.
⁵ School of Psychological Sciences and Honorary Professor, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
⁶ The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand.
⁷ Faculty of Medicine, University of Queensland, and Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁸ Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia.
⁹ School of Public Health, University of Queensland, Brisbane, Australia.
¹⁰ Department of Drug and Alcohol Treatment, Monash Health, Melbourne, Australia.
¹¹ Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
¹² Turning Point, Eastern Health, Monash University, Melbourne, Australia.
¹³ Uniting Care ReGen, Melbourne, Australia.
¹⁴ Quit Victoria, Melbourne, Australia.

PMID: 38653554
DOI: 10.1111/dar.13850

Abstract

Introduction: Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service clients' experiences of two types of nicotine products for smoking cessation post-discharge, combination nicotine replacement therapy (cNRT) and nicotine vaping products (NVP).

Methods: We held semi-structured telephone interviews with 31 Australian AOD service clients in a clinical trial of a 12-week smoking cessation intervention using Quitline support plus cNRT or NVP delivered post-discharge from a smoke-free residential service. We asked about health and social factors, nicotine cravings, Quitline experience, and barriers and facilitators to cNRT or NVP, then thematically analysed data.

Results: cNRT and NVP were described by participants as feasible and acceptable for smoking cessation. For most participants, cost limited cNRT access post study, as did difficulty navigating NVP prescription access. Quitline support was valued, but not consistently used, with participants noting low assistance with NVP-facilitated cessation. Participants considered both cessation methods acceptable and socially supported, and sought information on decreasing nicotine use via NVP.

Discussion and conclusions: AOD service clients highly valued receiving cNRT or NVP with behavioural support for smoking reduction or abstinence. Both interventions were acceptable to service clients. Findings suggest a potential need to examine both whether NVP use should be permitted in this context, and guidance on the individual suitability of cNRT or NVP.

Keywords: alcohol and other drugs; nicotine replacement therapy; smoking cessation; vaping; withdrawal treatment.

Abstract

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