Nicotine Replacement Therapy Research Paper Example

Introduction

This article focuses on the use of a single-system-design model, specifically the Interrupted Time Series design to stage an intervention for a female subject. The quasi-experimental design utilizes a set of longitudinal data to evaluate the effect of an intervention (Wong & O'Driscoll, 2017). The researcher will use the Interrupted Time Series to evaluate a relative, who has signed a consent form, and whose details will remain confidential before and after the intervention. The researcher chose this method because it is arguably the best alternative approach for handling interventions when clinical trials are unavailable. The subject is a 37-year-old Caucasian female named RM. She smokes between 16 and 20 packets a day and her favorite brand is Newport Menthol. She has been smoking for the last 15 years and made the decision to quit smoking five years ago and has tried to quit smoking twice during this time and failed both times. Her motivation to quit smoking is driven by the fear of re-contracting tuberculosis. She suffered the disease five years ago and the doctor told her that smoking increases the chances of reoccurrence of the condition, especially as one grows older. The subject identified addiction to nicotine as the target problem and would like to undertake the Nicotine Skin Patch therapy to alleviate the addiction entirely so she can lead a healthier life.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Literature Review

Approximately 23.5% of Americans smoke and out of these, about 75% have the intention of stopping the smoking habit (Piper et al., 2016). More than 80% of smokers try to stop without accessing any form of professional help, but unfortunately, only about 10% of them succeed. Only about 10% of the individuals who attempt to quit smoking without the intervention of a professional success in their quest (Voci, Hussain, & Selby, 2016). As such, the prevalent attitude among smokers is that quitting smoking is a next to impossible task, and when one tries and fails, they simply stop trying. Instead, smokers choose to continue with the habit without realizing that quitting the smoking habit can be so much easier when done collaboratively, or through the intervention of a professional.

A growing body of literature has sought to examine the potential causes of substance abuse, specifically cigarette smoking (Rahman et al., 2015). The revelation is that psychological distress, which is closely related to depression and anxiety, increases the likelihood of substance abuse, especially among people aged below 35 years. The negative effects of psychological distress increase the likelihood of smoking among non-users and an increase in the intensity of smoking among existing users. When smokers experience a negative mood during a depressive episode, the normally interpret it as a cue for smoking heavily. The cue exposure theory suggests that addictive behaviors develop chiefly due to the role played by cues. Two types of cues exist: interceptive and exteroceptive (Hwang & Yun, 2015). The latter pertains to a cue caused by the presence of cigarettes at certain times of the day while the latter pertains to associations with a negative mood or emotions. Whenever a substance user experiences either of the cues, the exposure triggers feelings of the need for something as a response. Past smoking addiction studies have revealed that addictive smoking is linked to interceptive cues. The coping theory explains that addiction to smoking is a psychological coping mechanism in that it acts as a temporary escape from psychological distress. In short, anxiety or sadness exposes people to multi-faceted nicotine addiction in the form of substance abuse (smoking).

Methodology

The study selection used an experimental design of a single subject research design (SSRD). The study includes a study of a single subject who has been smoking for fifteen years and has suffered negative health consequences as a result. The diagnostic information was provided through a review of a clinical diagnosis from the subject's hospital records. The selected intervention was a Nicotine Replacement Therapy and primary dependent variables for the study were related to the relationship between nicotine addiction and the effort used by the subject to quit smoking. The subject will record the frequency of his smoking on a tally sheet per day. Using the ABA design, the time frame allocated for the study was 15 days. The breakdown of the time was baseline, intervention, and follow-up steps, each of which was completed in a 5-day interval. Ethical decision making was upheld in the study in the form of providing full disclosure to the participant including the specific study procedures to be used. Moreover, full disclosure and guaranteed were guaranteed.

Data collection was done for the Nicotine Skin Patch as an intervention for RM's cessation of smoking. It would be applied for 45 minutes each day. RM was provided with several tally sheets by the researcher and was advised to keep the tally sheets near his packet of cigarettes in the living room. The researcher instructed RM to mark the tally sheet each time she lit a cigar from the time she woke up to the time she went to sleep. It was recommended that he mark the tally sheet after smoking to also record the number of cigarettes that were consumed each time. This method of recording was chosen to provide the researcher with insight concerning the level of dependence that RM has on cigarettes (low addiction, medium addiction, and high addiction).

A baseline of the frequency of smoking was recorded for 5 days. The researcher applied the skin patch on the 6th day in the morning at 8.00 am as RM started her day. It stayed on for 10 hours and the researcher removed it at 8.00 pm on the same day. She used 5 different patches for each day, each containing 21 mg of nicotine each. The patch was applied directly to the skin, at the same time each day. The patch was applied on the clean, dry, and hairless part of RM's left side of the upper arm. This part was chosen because it did not have any signs of irritation, broken skin, or oiliness, to prevent it from becoming loose and falling off. Only one single patch was used per day and at any one time. The application of the Nicotine Replacement Therapy intervention went on for 5 days, after which the researcher terminated it. After the intervention, the subject continued to record his smoking frequency from morning to evening for the next five days after the Nicotine Skin Patch intervention was terminated.

Discussion of Results

After analyzing the data for the smoking addiction the results revealed that the smoking frequency for the Nicotine Replacement Therapy intervention was lower than the frequency for smoking on four out of the five days being compared. Was even lower than that of the intervention frequency in three out of five days being compared. The chart below represents the results of the intervention graphically:

The chart above shows RM's smoking trend in the baseline stage, intervention, and during follow up. The first 5 days show that RM's smoking frequency increased and decreased within the given time frame. The highest drop in the frequency of smoking was noted during the intervention, after which the frequency rose slightly during the follow-up stage. The third stage was characterized a sharp rise on the first day of the follow up (11th day overall) and a steady decline in the frequency of smoking until the last two days of the intervention when no smoking was recorded. The smoking frequency in the baseline period was the highest followed by the follow-up period whereas RM recorded the lowest smoking rates during the intervention. In fact, the smoking frequency during the intervention, when the skin patch was applied, halved in comparison to the baseline. From this trend, it is clear that the implementation of the Nicotine Skin Patch intervention will reduce the smoking frequency greatly by combating the addictive effects of nicotine.

Having completed the single system research interview using the Interrupted Time Series approach and reviewing the literature on smoking and nicotine addiction, the researcher believes that the chosen intervention was fitting, appropriate, and provided satisfactory results. The Nicotine Skin Patch intervention was only administered for 15 days and a significant change was observed. To this end, the researcher believes that a lengthier application of this intervention would have provided even more tremendous results. To this end, the researcher recommends that the skin patch intervention is used to treat smoking addictions for RM's problem as well as for other individuals with similar addiction issues. As long as a user understands the nicotine replacement therapy behind the patch, they can use it effectively by sticking it to the skin each morning, rather than smoking a cigarette. The period of intervention was relatively short (15 days), yet RM reported that the skin patch's ability to take the edge off during the smoking withdrawal period helped her to manage her cravings. It also helped her to concentrate, manage restlessness and feelings of anxiety comfortably.

This Interrupted Time Series approach presents some limitations and as such, there is need to make some modifications and adjustments to the intervention. First, its external validity is limited since it is impossible to generalize the observations of the experiment beyond a single participant (Burris et al., 2015). To overcome this limitation, the researcher should replicate the intervention after two months using the same participant over the same time period and under similar circumstances. If the results of the second experiment align with the initial results, then validity is established (Royse, 2007). Secondly, the researcher was faced with this challenge considering that research in human services faces numerous practical limitations, hence the use of random sampling remains at a minimum. Recruiting participants for a study, who are willing to participate willingly from the beginning to the end is challenging especially to individuals who may lack the leverage of powerful networks. More so the challenge of convincing institutions to participate faces barriers, especially in sensitive research such as nicotine addiction. Moreover, the aspect of data biases is a strong limiting factors in inferential statistics, more so for Interrupted Time Series designs. The fact that it relies solely on visual data augments the likelihood of missing valid but trivial effects and also making exaggerated claims about an observation. To overcome this limitation, time series interventions should be used for massive numbers of data points.

Conclusion

RT, a 37-year-old Caucasian female showed immense progress in stopping her smoking habit, which is caused by nicotine addiction, over 15 days of ABA administration of Nicotine Replacement Therapy. According to the literature reviewed, addiction to nicotine is caused by a cue which is associated with distress and anxiety. As such, it becomes hard for people who are addicted to smoking to cut the habit since they interact with the cues that create the urge to smoke every day. However, replacement of cigarettes with a skin patch proved to be effective as it took the edge off, helping RM to reduce the smoking frequency by half during the intervention stage and the follow up as compared to the baseline stage. The researcher concluded that the skin patch is an effective intervention for combating nicotine addiction, although it was advised that a replication of the experiment be done to increase the validity of the findings.

References

Hwang, J., & Yun, Z. S...