Does improved access and greater choice of nicotine replacement therapy affect smoking cessation success? Findings from a randomized controlled trial

Authors

  • Natalie Walker,

    Corresponding author
    1. Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Colin Howe,

    1. Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Chris Bullen,

    1. Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Michele Grigg,

    1. Litmus, Wellington, New Zealand
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    • Formerly of The Quit Group, PO Box 12605, Wellington, New Zealand.

  • Marewa Glover,

    1. Centre for Tobacco Control Research, Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Hayden McRobbie,

    1. Queen Mary University of London, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Charterhouse Square, London, UK
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    • Formerly of the Clinical Trials Research Unit, School of Population Health, The University of Auckland, Private Bag 92019, Auckland, New Zealand.

  • Murray Laugesen,

    1. Health NZ Ltd, Lyttelton, Christchurch, New Zealand
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  • Joy Jiang,

    1. Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Mei-Hua Chen,

    1. Eli Lilly and Company (New Zealand) Limited, Newmarket, Auckland, New Zealand
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    • Formerly of the Clinical Trials Research Unit, School of Population Health, The University of Auckland, Private Bag 92019, Auckland, New Zealand.

  • Robyn Whittaker,

    1. Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand
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  • Anthony Rodgers

    1. The George Institute for International Health, NSW, Australia
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    • Formerly of the Clinical Trials Research Unit, School of Population Health, The University of Auckland, Private Bag 92019, Auckland, New Zealand.


Natalie Walker, Clinical Trials Research Unit, School of Population Health, The University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail: n.walker@ctru.auckland.ac.nz

ABSTRACT

Aims  To determine the effect of offering smokers who want to quit easy access to nicotine replacement therapy (NRT), a period of familiarization and choice of product on smoking abstinence at 6 months.

Design  Single-blind, randomized controlled trial.

Setting  New Zealand.

Participants  A total of 1410 adult smokers who called the national Quitline for quitting support were randomized to usual Quitline care or a box containing different NRT products (patch, gum, inhaler, sublingual tablet, oral pouch) to try for a week prior to quitting, and then to choose one or two of these products for 8 weeks' use.

Measurements  The primary outcome was 7-day point prevalence smoking abstinence 6 months after quit day. Secondary outcomes included continuous abstinence, cigarette consumption, withdrawal, NRT choice and serious adverse events at 1 and 3 weeks and 3 and 6 months.

Findings  No differences in 6-month quit rates (7-day point prevalence or continuous abstinence) were observed between the groups. However, smokers allocated to the intervention group were more likely to have quit smoking at 3 months [self-reported point prevalence, relative risk (RR) = 1.17, 95% confidence interval (CI): 1.02, 1.35, P = 0.03], had a longer time to relapse (median 70 days versus 28 days, P < 0.01) and used significantly more NRT. The selection box concept was highly acceptable to users, with the patch and inhaler combination the most popular choice (34%).

Conclusions  In terms of smoking abstinence at 6 months, offering smokers who want to quit free access to a wide range of nicotine replacement therapy, including a 1-week period of familiarization and choice of up to two products, appears no different to offering reduced cost and choice of nicotine replacement therapy, with no familiarization period.

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