Format

Send to

Choose Destination
Addiction. 2020 Jan 8. doi: 10.1111/add.14953. [Epub ahead of print]

Nicotine replacement therapy sampling for smoking cessation within primary care: Results from a pragmatic cluster randomized clinical trial.

Author information

1
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina (MUSC).
2
Department of Public Health Sciences, MUSC.
3
Hollings Cancer Center, MUSC.
4
now with American Society of Clinical Oncology.
5
Greenville Health System and Care Coordination Institute.

Abstract

BACKGROUND AND AIMS:

Within the context of busy clinical settings, healthcare providers need practical, evidence-based options to engage smokers in quitting. Sampling of nicotine replacement therapy (i.e., provision of NRT starter kits) is a brief, pragmatic strategy to address this need. We aimed to compare the effects of NRT sampling plus standard care (SC), relative to SC alone, provided by primary care providers during routine clinic visits.

DESIGN:

Cluster-randomized clinical trial.

SETTING:

22 primary care clinics in South Carolina, USA.

PARTICIPANTS:

Adult smokers (N=1245; 61% female, mean age 50.7, (SD=13.5) both motivated and unmotivated to quit, seen during routine clinical visit.

INTERVENTIONS:

Provider-delivered SC (n=652, 12 clinics) cessation advice, or SC + a two-week supply of both nicotine patch and lozenge, with minimal instructions on use (n=593; 10 clinics).

MEASUREMENTS:

The primary outcome was 7-day point prevalence smoking abstinence at 6-month follow-up, using intent-to-treat. Additional outcomes included NRT use and quit attempts, assessed at 1, 3, and 6 months following baseline.

FINDINGS:

Seven-day point prevalence abstinence rates were significantly higher in the NRT sampling group throughout follow-up, including at 6 months (12% vs. 8%; Odds Ratio [OR] = 1.5; 95% Confidence Interval [CI]: 1.0 - 2.4). NRT sampling increased prevalence of any use of NRT (65% vs. 25%; OR = 5.8; 95% CI: 4.3 - 7.7), with higher prevalence of use at 6 months (25% vs. 14%; OR = 2.0; 95% CI: 1.5 - 2.7). NRT sampling increased the rate of quit attempts in the initial month (24% vs. 18%; OR = 1.5; 95% CI: 1.0 - 2.3) but had no significant effect on overall rate of quit attempts (48% vs. 45%; OR = 1.2; 95% CI: 0.8 - 1.7).

CONCLUSION:

Providing smokers with a free 2-week starter kit of nicotine replacement therapy increased quit attempts, use of stop smoking medications, and smoking abstinence compared with standard care in a primary care setting.

KEYWORDS:

Cessation Induction; Pragmatic Clinical Trial; Primary Care; Smoking Cessation

PMID:
31916303
DOI:
10.1111/add.14953

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center