Effectiveness of stop-smoking medications: findings from the International Tobacco Control (ITC) Four Country Survey
Article first published online: 14 AUG 2012
Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Volume 108, Issue 1, pages 193–202, January 2013
How to Cite
Kasza, K. A., Hyland, A. J., Borland, R., McNeill, A. D., Bansal-Travers, M., Fix, B. V., Hammond, D., Fong, G. T. and Cummings, K. M. (2013), Effectiveness of stop-smoking medications: findings from the International Tobacco Control (ITC) Four Country Survey. Addiction, 108: 193–202. doi: 10.1111/j.1360-0443.2012.04009.x
- Issue published online: 26 DEC 2012
- Article first published online: 14 AUG 2012
- Manuscript Accepted: 29 JUN 2012
- Manuscript Revised: 9 APR 2012
- Manuscript Received: 22 FEB 2012
- US National Cancer Institute. Grant Numbers: P50 CA111326, P01 CA138389, R01 CA100362
- Canadian Institutes of Health Research. Grant Numbers: 57897, 79551, 115016
- National Health and Medical Research Council of Australia. Grant Numbers: 265903, 450110, 1005922
- Cancer Research UK. Grant Numbers: C312/A3726, C312/A6465, C312/A11039
- Robert Wood Johnson Foundation. Grant Number: 045734
- Canadian Tobacco Control Research Initiative. Grant Number: 014578
- Propel Centre for Population Health Impact
- Ontario Institute for Cancer Research
- Canadian Cancer Society Research Institute
- Nicotine replacement therapy;
- population effectiveness;
- recall bias;
- smoking cessation;
- stop-smoking medication;
To evaluate the population effectiveness of stop-smoking medications while accounting for potential recall bias by controlling for quit attempt recency.
Prospective cohort survey.
United Kingdom, Canada, Australia and the United States.
A total of 7436 adult smokers (18+ years) selected via random digit dialling and interviewed as part of the International Tobacco Control Four Country Survey (ITC-4) between 2002 and 2009. Primary analyses utilized the subset of respondents who participated in 2006 or later (n = 2550).
Continuous abstinence from smoking for 1 month/6 months.
Among participants who recalled making a quit attempt within 1 month of interview, those who reported using varenicline, bupropion or nicotine patch were more likely to maintain 6-month continuous abstinence from smoking compared to those who attempted to quit without medication [adjusted odds ratio (OR) 5.84, 95% confidence interval (CI) (2.12–16.12), 3.94 (0.87–17.80), 4.09 (1.72–9.74), respectively]; there were no clear effects for oral NRT use. Those who did not use any medication when attempting to quit tended to be younger, to be racial/ethnic minorities, to have lower incomes and to believe that medications do not make quitting easier.
Consistent with evidence from randomized controlled trials, smokers in the United Kingdom, Canada, Australia and the United States are more likely to succeed in quit attempts if they use varenicline, bupropion or nicotine patch. Previous population studies that failed to find an effect failed to control adequately for important sources of bias.