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. 2020 Jul;115(7):1358-1367.
doi: 10.1111/add.14953. Epub 2020 Jan 30.

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

Matthew J Carpenter  1   2   3 , Amy E Wahlquist  2   3 , Jennifer Dahne  1   3 , Kevin M Gray  1   3 , Elizabeth Garrett-Mayer  2   3 , K Michael Cummings  1   2   3 , Robert Davis  4 , Brent M Egan  4
Affiliations

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

Matthew J Carpenter et al. Addiction. 2020 Jul.

Abstract

Background and aims: Within the context of busy clinical settings, health-care providers need practical, evidence-based options to engage smokers in quitting. Sampling of nicotine replacement therapy [i.e. provision of nicotine replacement therapy (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: Twenty-two primary care clinics in South Carolina, USA.

Participants: Adult smokers [n = 1245; 61% female, mean age = 50.7, standard deviation (SD) = 13.5] both motivated and unmotivated to quit, seen during routine clinical visit. Interventions were provider-delivered SC (n = 652, 12 clinics) cessation advice or SC + a 2-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 versus 8%, odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.0-2.4]. NRT sampling increased prevalence of any use of NRT (65 versus 25%, OR = 5.8, 95% CI = 4.3-7.7), with higher prevalence of use at 6 months (25 versus 14%, OR = 2.0, 95% CI = 1.5-2.7). NRT sampling increased the rate of quit attempts in the initial month (24 versus 18%, OR = 1.5, 95% CI = 1.0-2.3) but had no significant effect on overall rate of quit attempts (48 versus 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; nicotine replacement therapy; pragmatic clinical trial; primary care; smoking cessation.

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Figures

Figure 1:
Figure 1:
Recruitment Flow and Retention
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References

    1. Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ. et al. Treating tobacco use and dependence: 2008 Update Clinical Practice Guideline Rockville, MD: US Public Health Service; 2008.
    1. Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation (Cochrane Review) The Cochrane Library, Issue 3, Oxford: Wiley Publishers; 2008. - PubMed
    1. Kruger J, O’Halloran A, Rosenthal A. Assessment of compliance with US public health service clinical practice guideline for tobacco by primary care physicians, Harm Reduction Journal 2015: 12: 7. - PMC - PubMed
    1. Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: An overview and network meta-analysis Cochrane Database of Systematice Reviews, Oxford: John Wiley & Sons; 2013. - PMC - PubMed
    1. Shah SD, Wilken LA, Winkler SR, Lin SJ. Systematic review and meta-analysis of combination therapy for smoking cessation, Journal of the American Pharmacists Association 2008: 48: 659–665. - PubMed

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