Nursing Research 2(1).REVISED(1)

Nursing Research 2Research Proposal

Presented by: Cassandra

Clarice ChengDiana Joseph

Evan TangMelody Chow

Zhang Si En

Contents

Introduction Literature Review Hypotheses Ethical Considerations Research Design Sampling Procedure Data Collection Procedure Data Analysis Discussion Conclusion Acknowledgement

TITLE

The Effectiveness of Using Nicotine Patch in Smoking Cessation Among Smoking Adolescents.

Introduction

Tobacco is the single greatest cause of morbidity and mortality in the United States today, responsible for approximately 440,000 premature deaths and US$157 billion in health-related economic losses per year (Centers for Disease Control, 2002).

Literature review• The effect of NRT on craving and withdrawal is robust, and a prior study showed that NRT patches can reduce craving and withdrawal during the initial treatment phase(TNSG, 1991).

• Studies have shown that using NRTs can be helpful in a person’s quitting smoking program and that using the nicotine patch can double the rate of success with smoking cessation.(Terry Martin,2010)

Literature Review

Smokers, might have longer-lasting symptoms that could benefit from treatment with NRT. (Hughes.1992; Hughes et al, 1991; West & Schneider, 1987)

Despite limited effects on cessation in the open-label youth trials,(TA smith et al 1996),Transdermal nicotine therapy was associated with significant self-reported decreases in cigarette consumption.(RD Hurt et al 2000)

Research Question

• Among adolescents who smoke, does the use of nicotine patch therapy effective in aiding smoking cessation?

HYPOTHESIS

Increased usage of nicotine patch leads to a higher rate of Smoking Cessation.

Research Design

Convenient Sampling

Longitudinal

Sequence of events: Questionnaires and follow up interview with the people who declared their smoking status.

Ethical Considerations

Seek approval from Ngee Ann Polytechnic and Singapore Polytechnic ‘s Directors.

Obtain consent from students to participant in the survey.

Confidentiality form will be signed as part of the agreement.

Ensure that the completed questionnaires will be kept in a password-access cupboard only to be accessed by the researchers.

Researchers to sign an indemnity form confirming the confidentiality of the participants.

Setting

Smoking areas outside Singapore Polytechnic and Ngee Ann Polytechnic i.e. under the bridge.

Toilets Staircases School Entrance Back gate

Research sample: 300 smoking adolescents.

Before the start of the study, smoking hotspots have already been surveyed and identified.

The time where there are most smokers in the area was targeted.

Survey forms were given and particulars of the smokers were taken down.

Sampling Procedure

Meeting with smokers was arranged and carbon monoxide breath tests

was done and initial results were recorded.

A 3 months supply of nicotine patch will be given.

Communication via text messages or phone calls between researchers

and the participants will be conducted.

Carbon monoxide breath test will be done after 3 months to determine the decrease in levels.

Measurements

Questionnaires Surveys Smokalyser Considering validity and reliability,

questionnaires seem to be the optimal choice. As students will be asked close-ended questions, they will find it easier to answer.

Data Collection

Students participating were from Ngee Ann Polytechnic and Singapore Polytechnic. Students will receive forms to complete (i.e., survey forms, demographic form, and consent form).

The participants will be asked to undergo the smokalyser test.

Data collected will be kept under lock and key.

The key will only be access by the researchers.

Data Analysis

Data will be entered into Microsoft Excel.

Data will be analyzed using paired T test.

P value will be calculated to conclude if our hypotheses is acceptable and valid.

Discussion

Implications Health education talks on the risks of smoking will

be conducted at primary, secondary and tertiary schools.

Media advertisements – hand outs, brochures and campus radio.

Smoking cessation campaigns targeted at the adolescents.

Example of a brochure to be handed out:

Limitations Might not be able to get enough data. Participant might not be cooperative. Data might not be completed. Blood Test and urinalysis should have been

done for accuracy. Sample size small.

Terms & Conditions

The participants can withdraw from this study at any given time.

Any information belonging to the participants will be kept private and confidential.

All participants will follow the instructions given.

Conclusion Improves the practices of smoking cessation

using nicotine patch. Create awareness among adolescents on the

risks of smoking. Provide more information and benefits on the

usage of nicotine patches. Eventual quitting in smoking among

adolescents.

Consent form

INFORMED CONSENT

Protocol Title: Nicotine Replacement Therapy Research

Please read this consent document carefully before you decide to participate in this study.

Purpose of the research study: To determine the effectiveness of nicotine patches in smoking

cessation.

What you will be asked to do in the study:

Time required: 6 Months

Risks and Benefits: There are no risks. However, the benefits are that there are chances of quitting

smoking and information about nicotine patches.

Confidentiality: Your identity will be kept confidential to the extent provided by law. Your information will

be assigned a code number, in lieu of any personally identifying information. The list connecting your

name to this number will be kept in a locked file. When the study is completed and the data has

been analyzed, the list will be destroyed. Your name will not be used in any report.

Voluntary participation: Your participation in this study is completely voluntary. There is no penalty for

not participating. You may also refuse to answer any of the questions we ask you.

Right to withdraw from the study: You have the right to withdraw from the study at anytime without

consequence.

Whom to contact if you have questions about the study:

Whom to contact about your rights as a research participant in the study:

Zhang Si En

Phone:64479011

FAX: 65649022

E-mail: [email protected]

Agreement:

I have read the procedure described above. I voluntarily agree to participate in the procedure and I

have received a copy of this description.

Participant: ___________________________________________ Date: _________________

Principal Investigator: ___________________________________ Date: _________________

Survey form1. Are you a smoker? Yes / NoIf yes, please continue on to answer the questions. If no, please ignore the rest of the questions.

2. What is your gender? Male / Female 3. Which age group do you belong to 12-16 years old 17-21 years old4. How many sticks do you smoke a day?1-5 sticks 6-10 sticks 11-15 sticks 16-20 sticks More than 1 pack5. What brand of cigarettes do you normally use? (Able to choose more than one)

Viceroy Malboro Texas Dunhill Break Sampoerna Winner Pall Mall

Others: _____________________(please specify)

6. Have you ever thought or tried to quit smoking?Yes / No 

If yes, please proceed to answer the following questions. If no, please ignore.

7. Have you ever tried using nicotine replacement therapy (i.e. nicotine gum, nicotine patch)?  Nicotine gum Nicotine patchOthers: ____________________ (please specify)

 8. Do you find it effective in helping you to abstain from smoking?Yes / No

Budgeting

ITEMS PRICE

Questionnaire printing (3 cents/pc) $9

Consent form printing (3 cents/pc) 600pc $18

Brochure printing (0.47/ unit) $141

Nicotine patches (17.80/box) 2700 boxes

$48060

Breathalyzer (4-9 units $74.95 each) $374.75

Breathalyzer mouth piece (18.95/30pcs) $189.50

In Total : $48,792.25

After sponsoring of nicotine patches: $732.25

TimelineYear/Month 1st 2nd 3rd 4th

2011 Jan

Feb

March

April

May

June

July

Aug

Sept

Oct

Nov

Dec

FINAL REPORT WRITING

PROPOSAL

COLLABORATING WITH POLYCLINICS AND NICOTINE PATC MANUFACTURER AND APPROVAL FROM POLYTECHNICS

BUY & PRINT

RECRUIT PARTICIPANTS, SURVEY, TELEPHONE MESSAGES

INTERVIEW

FOLLOW-UP WITH BREATHALYSER

RESULTS ANALYSIS

IMPLEMENTATION OF IMPLICATION

References Shiffman, S., Rolf ,CN., Hellebush, SJ., Gorsline, J., Gorodetzky, CW.,

Chiang, YK., Schleusener, DS., Marino, MED. (2002). Real-world efficacy of prescription and over-the counter nicotine replacement therapy. Society For The Study Of Addiction To Alcohol and Other Drugs, 97, 505-516.

Anthony J. Alberg, Ruth Stashefsky Margalit, Alyce Burke, Kimberly A. Rasch, Nell Stawart, Jo Ann Kline, Paula A. Ernst, Amy Avvey, Sandra C. Hoffman. ( 2004). The Influence of offering free transdermal nicotine patches on the quit rates in local health department’s smoking cessation program. Addictive Behaviours, 29, 1763- 1778

All About The Nicotine Patch, by Terry Martin, About.com Guide Updated June10,2010 website:http://quitsmoking.about.com/od/nrts/a/nicotinepatch.htm

Shiffman, Saul, Khayrallah, Moise, & Nowak, Robert. (2000). Efficacy of the nicotine patch for relief of craving and withdrawal 7-10 weeks after cessation. 2, 371-378.

Smith TA, House RF Jr, Croghan IT, et al. Nicotine Patch therapy in adolescent smokers. Pediatrics. 1996;98:659-667

Hurt RD, Croghan GA, Beede SD, Wolter TD, Croghan IT, Patten CA. Nicotine patch therapy in 101 adolescent smokers: efficacy , withdrawal symptom relief, and carbon monoxide and plasma cotinine levels. Arch Pediatr Adolesc Med. 2000;154:31-37

Acknowledgement

We would like to thank Dr. Phang, our director of Health Sciences to give us the opportunity to conduct our research.

We would like to thank Ms Marine for her guidance and patience throughout the process.

We would like to thank the students who participant in our study

Special thanks to: Dr Phang

Miss Marine

Singapore Polytechnic

Ngee Ann Polytechnic