Does the number of free nicotine patches given to smokers calling a quitline influence quit rates: results from a quasi-experimental study.

K Michael Cummings,Martin Mahoney,Paula Celestino,Brian V Fix,Deborah J Ossip,Andrew Hyland,Ursula Bauer

doi:10.1186/1471-2458-10-181

Abstract

BackgroundThe offer of free nicotine replacement therapy (NRT) can be a cost-effective marketing strategy to induce smokers to call a telephone quitline for quitting assistance. However, the most cost-effective supply of free NRT to provide to smokers who call a quitline remains unknown. This study tests the hypothesis that smokers who call a telephone quitline and are given more free nicotine patches would report higher quit rates upon follow-up 12 months later.MethodsA quasi-experimental design was used to assess nicotine patch usage patterns and quit rates among five groups of smokers who called the New York State Smokers' Quitline (NYSSQL) between April 2003 and May 2006 and were mailed 2-, 4-, 6- or 8-week supplies of free nicotine patches. The study population included 2,442 adult (aged 18 years or older) current daily smokers of 10 or more cigarettes per day, who were willing to make a quit attempt, and reported no contraindications for using the nicotine patch. Outcome variables assessed included the percentage of smokers who reported that they had not smoked for at least 7-days at the time of a 12 months telephone follow-up survey, sustained quitting, delayed quitting and nicotine patch use.ResultsQuit rates measured at 12 months were higher for smokers in the groups who received either 2, 6, or 8 weeks of free patches. The lowest quit rate was observed among the group of Medicaid/uninsured smokers who were eligible to receive up to six weeks of free patches. The quit rate for the 4-week supply group did not differ significantly from the 6-week or 8-week groups. These patterns remained similar in an intent-to-treat analysis of 12-month quit rates and in an analysis of sustained quitting.ConclusionNo clear cut dose response relationship was observed between the number of free nicotine patches sent to smokers and smoking outcomes. Baseline diferences in the characteristics of the groups compared could account for the null findings, and a more definitive randomized trial is warranted.

Highlights

The offer of free nicotine replacement therapy (NRT) can be a cost-effective marketing strategy to induce smokers to call a telephone quitline for quitting assistance
The number of program participants who reported obtaining an additional supply of nicotine patches, beyond the patches furnished by the New York State Smokers’ Quitline (NYSSQL), was 11%
This study utilized data collected from different groups of smokers who had contacted the New York Smokers Quiltine over the past 4 years and received different amounts of free nicotine patches to try to answer the question of whether the amount of free patches given to smokers affected quitting outcomes

Summary

Introduction

The offer of free nicotine replacement therapy (NRT) can be a cost-effective marketing strategy to induce smokers to call a telephone quitline for quitting assistance. Research has demonstrated that the offer of free nicotine replacement therapy (NRT) can be a cost-effective marketing strategy to induce large numbers of smokers to call a telephone quitline for quitting assistance [1,2,3]. Two randomized trials have examined the effects of varying the duration of NRT, and neither found any benefit from extending treatment from 12 weeks to 18 or 26 weeks [10,11] Neither of these studies addressed the value of giving smokers different amounts of free medications at the outset of their quit attempt

Methods

Results

Conclusion