Document Detail


Enhancing tobacco quitline effectiveness: identifying a superior pharmacotherapy adjuvant.
MedLine Citation:
PMID:  22992296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Telephone tobacco quitlines are effective and are widely used, with more than 500,000 U.S. callers in 2010. This study investigated the clinical effectiveness and cost-effectiveness of 3 different quitline enhancements: combination nicotine replacement therapy (NRT), longer duration of NRT, and counseling to increase NRT adherence.
METHODS: In this study, 987 quitline callers were randomized to a combination of quitline treatments in a 2 × 2 × 2 factorial design: NRT duration (2 vs. 6 weeks), NRT type (nicotine patch only vs. patch plus nicotine gum), and standard 4-call counseling (SC) versus SC plus medication adherence counseling (MAC). The primary outcome was 7-day point-prevalence abstinence (PPA) at 6 months postquit in intention-to-treat (ITT) analyses.
RESULTS: Combination NRT for 6 weeks yielded the highest 6-month PPA rate (51.6%) compared with 2 weeks of nicotine patch (38.4%), odds ratios [OR] = 1.71 (95% confidence interval [CI]:1.20-2.45). A similar result was found for 2 weeks of combination NRT (48.2%), OR = 1.49 (95% CI: 1.04-2.14) but not for 6 weeks of nicotine patch alone (46.2%), OR = 1.38 (95% CI: 0.96-1.97). The MAC intervention effect was nonsignificant. Cost analyses showed that the 2-week combination NRT group had the lowest cost per quit ($442 vs. $464 for 2-week patch only, $505 for 6-week patch only, and $675 for 6-week combination NRT).
CONCLUSIONS: Combination NRT for 2 or 6 weeks increased 6-month abstinence rates by 10% and 13%, respectively, over rates produced by 2 weeks of nicotine patch when offered with quitline counseling. A 10% improvement would potentially yield an additional 50,000 quitters annually, assuming 500,000 callers to U.S. quitlines per year.
Authors:
Stevens S Smith; Paula A Keller; Kate H Kobinsky; Timothy B Baker; David L Fraser; Terry Bush; Brooke Magnusson; Susan M Zbikowski; Timothy A McAfee; Michael C Fiore
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-09-19
Journal Detail:
Title:  Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco     Volume:  15     ISSN:  1469-994X     ISO Abbreviation:  Nicotine Tob. Res.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  2013-08-13     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  9815751     Medline TA:  Nicotine Tob Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  718-28     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01087905
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MeSH Terms
Descriptor/Qualifier:
Adult
Chewing Gum
Cost-Benefit Analysis
Counseling
Female
Hotlines* / standards
Humans
Male
Middle Aged
Nicotine / economics,  therapeutic use*
Patient Compliance
Smoking / economics,  therapy*
Smoking Cessation / economics,  methods*
Telephone
Time Factors
Tobacco
Tobacco Use Cessation Products / standards*
Treatment Outcome
Wisconsin
Grant Support
ID/Acronym/Agency:
1RC1CA144382/CA/NCI NIH HHS; K05 CA139871/CA/NCI NIH HHS; K05CA139871/CA/NCI NIH HHS; RC1 CA144382/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Chewing Gum; 54-11-5/Nicotine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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