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Nicotine Replacement Therapy in Nicotine-dependent Arrestees

Phase 4
Completed
Conditions
Nicotine Dependence
Interventions
Drug: Nicotine patch
Other: placebo patch
Registration Number
NCT02905734
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Tobacco use affects more than 50% of adult arrestees, of which 70% are dependent on nicotine. However, they have no access to tobacco during detention in police cells. Nicotine withdrawal symptoms, that include irritability, anxiety and lack of concentration, may worsen the arrestee's health status during detention. Nicotine withdrawal is a treatable condition. Validated treatments in other situations than police custody include nicotine replacement therapy.

This study is based on the following hypotheses: Manifestations related to nicotine withdrawal could increase the discomfort due to detention in police cells, A nicotine replacement therapy initiated during detention could improve the course of detention in police cells and could be useful in a perspective of long-lasting smoking cessation.

The primary objective is to evaluate the efficacy of nicotine replacement therapy among nicotine-dependent arrestees on the course of detention as perceived by the arrestees. Our secondary objectives are to evaluate the efficacy of nicotine replacement therapy on desire to smoke during detention in police cells and to improve long-term smoking cessation among dependent smokers.

Interventions consist in the single administration of an active treatment (nicotine patch) or of a control treatment (placebo patch). Evaluations will include the results of a medical examination during detention, a self evaluation by the arrestees of their desire to smoke, and medical consultations and evaluations of tobacco use 7-10 days, one month and six months later.

Detailed Description

Police custody is a matter of significant public attention in France, as approximately 700,000 people are detained in police cells each year in this country.

Tobacco use affects more than 50% of adult arrestees, of which 70% are dependent on nicotine. However, they have no access to tobacco during detention in police cells. Nicotine withdrawal symptoms, including irritability, anxiety and lack of concentration, may worsen the arrestee's health status during detention. Nicotine withdrawal is a treatable condition. Validated treatments in other situations than police custody include nicotine replacement therapy. Available medical guidelines in police custody do not mention nicotine dependence.

This study is based on the following hypotheses: (1) Manifestations related to nicotine withdrawal could increase discomfort due to the detention in police cells, (2) A nicotine replacement therapy initiated during detention could improve the course of detention in police cells and (3) could be useful in a perspective of long-lasting smoking cessation.

The primary objective is to evaluate the efficacy of nicotine replacement therapy among nicotine-dependent arrestees on the course of detention as perceived by the arrestees. The secondary objectives are to evaluate the efficacy of nicotine replacement therapy on desire to smoke during detention in police cells and to improve long-term smoking cessation among dependent smokers.

Interventions consist in the single administration of an active treatment (nicotine patch) or of a control treatment (placebo patch). Evaluations will include the results of a medical examination during detention, a self-assessment by the arrestees of their desire to smoke, and medical consultations and evaluations of tobacco use 7-10 days, one month and six months later.

Primary endpoint: self-assessment of detention course by the arrestee (Likert scale).

Secondary endpoints: Desire to smoke during detention in police cells (Likert scale); willingness to change their tobacco use (Likert scale); tobacco use at 1 and 6 months.

Methods:

The study design includes two parts. The first part will be the intervention (patch administration) during detention in police cells: single blind randomized administration of a nicotine patch or a placebo patch. The second part will be observational and include follow-up evaluations at 7-10 days, 1 month and 6 months.

The active treatment will consist of a single administration of nicotine patches (21 mg/24h or 14 mg/24h according to the Heaviness of smoking index \[HIS\], 21 mg for those with HSI\>3, 14 mg for those with HSI of 1 or 2). The control treatment will be a non-active placebo patch.

Number of participants: 1000 (two groups of 500). The total duration of the study will be 33 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
800
Inclusion Criteria
  • Arrestees examined by a physician during detention in police cells
  • aged 18 or older
  • smoking at least 10 cigarettes per day
  • giving written consent to participate in the study
  • health status compatible with detention in police cells
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Exclusion Criteria
  • Lack of understanding of the study
  • contra-indication to nicotine replacement therapy
  • health status incompatible with detention in police cells
  • serious mental disorder
  • usual place of residence outside Seine-Saint-Denis
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
nicotine replacement patchNicotine patchSingle administration of a nicotine patch (14 mg or 21 mg, according to the Heaviness of Smoking Index)
placebo patchplacebo patchSingle administration of a placebo patch
Primary Outcome Measures
NameTimeMethod
Perceived quality of detention in police cells at 8 hours following treatment administration8 hours maximum after treatment

self-assessment of detention course by the arrestee (Likert scale).

Secondary Outcome Measures
NameTimeMethod
Rating of desire to smoke after treatment administration8 hours maximum after treatment

Desire to smoke during detention in police cells (Likert scale)

Rating of intention to quit smoking after treatment administration;8 hours maximum after treatment

willingness to change their tobacco use (Likert scale)

Mean number of cigarettes per day at one monthone month after treatment

tobacco use at 1 month consultation

Mean number of cigarettes per day at six monthssix months after treatment

tobacco use at 6 months consultation

Trial Locations

Locations (1)

Médecine légale - Hôpital Jean Verdier

🇫🇷

Bondy, France

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