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A combination nicotine replacement therapy (NRT) algorithm for hard-to-treat smokers
Renee Bittoun

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Abstract
Background: Many smokers have not succeeded in quitting using a single nicotine replacement mode.
Aim: An algorithm was developed for clinicians to enhance success rates when recommending Nicotine Replacement Therapy (NRT) to smoking patients.
Method: The algorithm is based on clinical experience with chronic smokers with respiratory illnesses attending one-on-one Smokers Clinics in the Central Sydney Area Health Service.
Method: Based on transdermal nicotine therapy (patch) other forms of NRT are added if required for "breakout" smoking for two weeks.
Results: Outcomes have shown 60% confirmed continuous abstinence at 3 months.
Conclusion: Smokers can be safely and successfully treated symptomatically for nicotine withdrawal relief using combination NRT aggressively. This enhances treatment efficacy by minimising relapse in the first few weeks and months of quitting.

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Biography
Has worked in Smoking Cessation for > 25 years. Set up first Smokers' Clinic in Australia at St.Vincent's Hospital, Sydney in 1979. Currently Director of the Smokers' Clinics, Central Sydney Area Health Service, Senior Research Fellow and Head of the Smoking Cessation Unit at the Woolcock Institute of Medical Research and Clinical Associate in the Faculty of Medicine at the University of Sydney. She is the author of several books on smoking and quitting both for the public and as texts and many research articles on smoking cessation. She established first university course on Nicotine Addiction and Smoking Cessation Course at University of Sydney and is President of AASCP, The Australian Association of Smoking Cessation Professionals.

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Renee Bittoun
Director Smokers Clinic, University of Sydney and Royal Prince Alfred Hospital
University of Sydney D06
Sydney
2006
Australia

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