Half of oral NRT delivered to smoker hospital staff are not use for tobacco cessation but for long term substitution

Our hospital offer free NRT on prescription for smoker staff. We explore how oral and patches NRT are delivered for the different users. Methods: All the 2012 NRT delivery notice of the chest dep. tobacco cessation clinic (TCS) are assessed to classified NRT users in 3 categories: 3-month or less NRT, 4 -12-month NRT, 2-7-year NRT because of nicotine addiction. Results: 87 smokers received 563 NRT boxes in 2012 (44.6% patches,55.4% oral NRT). 74 smokers (85%) (26M/48F) received NRT for 3 months or less (SC group). 4 smokers (5%) received 4-12 months NRT (3M/1F) (PC group). 9 smokers (10%) (7F/2M) received NRT for 2-7 years (Add group). The Add group received in 2012: patches +oral NRT (7), only patch (3) or only oral NRT (1). 71% of 2mg gum is delivered to the 9 Add group smokers who received also 46% of Microtab, 24% of inhaler and 17% of 4mg gums. So 50% of oral NRT is consumed by these 10% Add group users. This Add group received also 29% of patches, mainly 14mg and 10 mg (45% of boxes). Among the 5% of PC group smokers the more used products are 21mg patches (13% of boxes), 25 mg patches (11%) and inhaler (20%). The 85% SC group smokers use more patches (156 boxes) than oral NRT (128 boxes) when PC group use 22 boxes of patch for 29 of oral NRT and the 9 Add group smoker used more than 2 times more oral NRT than patches (155/73 boxes). Conclusion: 50% of oral NRT is use for long term substitution in addict former smokers. Patches are 71% used for cessation. Replacement of tobacco to medical nicotine addiction is a clear risk reduction but the 10% of NRT long term users in this population need attention as all non-tobacco delivery nicotine system users.