The smoking rate in Australia is a little over 17%. In 2004 18.6% of males smoked and 16.3% of females. Compare this to the indigenous population. In 2004 half of all indigenous Australians smoked (males 51%, females 49%). While the smoking rate across Australia has dropped it has not changed in our indigenous population.

It’s no surprise that smoking of tobacco is the major cause of the burdens of injury and disease. Smoking accounted for 20% of all indigenous deaths and 12.1% of the total burden of disease and injury.

The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that nicotine patches be placed on the pharmaceutical benefits scheme for indigenous Australians. This has allowed it to be provided in a 28 day pack on an authority prescription or through the Section 100 supply arrangements of pharmaceuticals to remote area Aboriginal Health Services.

Only one strength of one brand was approved. It was approved even before the company had a 28 day PBS pack available! There is now a regular supply of the PBS quantity nicotine patch.

The following was supplied by Graham Perl, Pharmacy Relations Manager, Johnson & Johnson Pacific. (I don’t usually promote companies or products but as this is the only patch available to assist Indigenous Australians I am making an exception.)

PBS Listing for Nicorette Patch 28’s

Nicorette 15mg/16 hour Patch 28-pack is now available as an Authority PBS listed product for Aboriginal and Torres Strait Islander people and Section 100 for those in regional and remote areas

Nicorette treats tobacco dependence by relieving nicotine craving and withdrawal symptoms, facilitating smoking cessation

PBS Indication:
Nicotine dependence in an Aboriginal or a Torres Strait Islander person

PBS Listing details
- Maximum quantity 28 patches (1 pack) plus 2 repeats (12 weeks treatment)
- Available on Section 100 for remote access
- Pack size of 28 patches (28 days treatment)
- Authority
- Maximum 2 courses of 12 week treatment per year

How is Nicorette Patch used?
- place patch on non-hairy, clean dry skin such as upper thigh, hip, under arm or chest (alternate application site each day)
- apply in the morning, remove at night (after about 16 hours)
- dispose by folding sticky sides together and disposal out of reach of children

Contra-indications
- generalised chronic dermatological disorders (eg: psoriasis, dermatitis, urticaria), non-smokers, children under 12 years of age

Precautions
- stable cardiovascular disease (unstable CV conditions require medical supervision)
- diabetes (blood sugar requires closer monitoring)
- Moderate to severe hepatic impairment and severe renal impairment (potential reduced clearance)
- Uncontrolled hyperthyroidism and phaeochromocytoma

Common adverse reactions
- local skin irritation, headache, indigestion, nausea, vomiting

Smoking and using Nicorette patch
- Continuing to smoke with Patch may increase nicotine-related side effects
- Intermittent forms of Nicorette e.g. gum and Inhaler (not PBS listed) while continuing to smoke (and trying to cut down) has not been shown to increase adverse effects related to nicotine)

Pregnancy / lactation and Nicorette
- Nicotine is harmful to the foetus. Ideally smoking cessation should be achieved without NRT. If not possible, it is preferable to use intermittent (gum/microtab/inhaler) forms of nicotine delivery as they provide a lower daily dose of nicotine. Risk with NRT is lower than that of smoking.
- Lactation – intermittent forms of NRT are preferable. Breastfeeding should occur just before using the product

Smoking relapse and continued craving
- combination therapy with Nicorette Patch plus 2 mg Nicorette gum may be necessary in patients who have relapsed in the past or experience cravings using single therapy. The combination is more effective than either product alone, increasing the patient’s chances of successful quitting. No more than12 x 2mg gum with Patch per day.

Nicorette contains nicotine. Stop smoking aid. Use only as directed.

Note that this is general information only and if you follow only this or believe it without speaking to your healthcare professional you are a bit of a wally.

If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. Visit my subscription page.