NRT in hospital settings

From a reader:

For many people, going in to hospital provides an opportunity to stop smoking … They also found that adding nicotine replacement therapy or bupropion to intensive treatment plans had some additional effect in helping people stop smoking over providing the intensive counselling alone, although the difference was not statistically significant.

Might be a bad idea – this study was written up in one of my critical care nursing journals recently:

Lee and colleagues examined the safety of NRT in the ICU … Among the patients who received NRT, 18 deaths (16.1%) occurred, compared with the 3 deaths (2.7%) in the control group. The hospital mortality rate was 21.4% for the NRT group, compared with 5.4% in the control group. Furthermore, when researchers controlled for severity of illness, NRT was found to be an independent risk factor for mortality (odds ratio 17.0)

Nicotine (inhaled or transdermal or whatever form) has many deleterious effects on the cardiovascular system, and probably on blood flow patterns, wound healing, immune response and other factors significant to people who are hospitalized vs. people who are not experiencing acute health problems.