Teaching Residents how to Effectively Prescribe Nicotine Replacement Therapy on the Clinical Teaching Unit

Cigarette smoking is the leading cause of preventable death. On the Clinical Teaching Unit, medical students and residents are well positioned to provide smoking cessation resources to patients with the aim of improving quit rates. However, there is a paucity of data evaluating their role in counselling patients on smoking cessation. A survey at our centre identified that medical trainees had a lack of knowledge regarding Nicotine Replacement Therapy (NRT) as a barrier to smoking cessation counselling. We hypothesized that a teaching session on NRT during an inpatient Internal Medicine rotation would increase learner comfort in prescribing these products. Medical trainees on the Internal Medicine Clinical Teaching Unit (CTU) attended a teaching session during week 4 of an 8-week rotation. Pharmacy records from the 8-week period were retrospectively analyzed to determine NRT prescribing behaviour. Pre-intervention, 5.8% (13/225) of new admissions received an NRT prescription. Post-intervention, 17% (31/182) of new admissions received an NRT prescription. Using a Fisher’s exact test, the percentage of new admissions that received a prescription was significantly different (p<0.001) between the pre- and post-intervention time frames. This data suggests that integrating education on NRT into CTU teaching can significantly alter prescribing behaviour and improve access to NRT for patients who need it.