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Eight-week nicotine replacement therapy program improves quit rates compared with a two-week program, study shows

Tuesday, August 19 2008 | Comments

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What's This? The integration of nicotine replacement therapy in a state-level tobacco quitline appears to improve quit rates among uninsured smokers during an eight-week period relative to a two-week program, while being cost-effective, a new study shows.

The study included 1,154 uninsured smokers who called the Oregon Quit Line and were randomized to receive a two-week (n=578) or eight-week (n=575) supply of nicotine patches during a free nicotine replacement therapy initiative from Oct. 18, 2004, to May 5, 2005. The smokers were aged 18 years or older, smoked five or more cigarettes per day and expressed an interest in quitting within 30 days. The participants were eligible to receive two phone counseling sessions and were able to call in for support on an ad hoc basis.

The primary outcome was self-reported complete abstinence from tobacco for 30 or more days at the six-month phone survey.

Study results showed that at six months, 14.3 percent of those who received the two-week supply of nicotine replacement patches had a 30-day tobacco abstinence compared with 19.6 percent of those in the eight-week nicotine replacement therapy group. At six months, the adjusted intent-to-treat 30-day quit rates of the eight-week therapy group indicated an absolute increase in quit rate of 5 percent. The odds of being abstinent for 30 days were 45 percent higher for those in the eight-week group relative to those in the two-week group.

In addition, the 90-day abstinence rates were 10.4 percent for the two-week group and 15.8 percent for the eight-week group. The odds of being abstinent for 90 days were 63 percent higher for those in the eight-week group as compared with those in the two-week group.

Those who received eight weeks of therapy were also more likely to be satisfied and to have actually used the patches. However, those who received two weeks of therapy were 2.5 times more likely to purchase more patches.

The average intervention costs were $165.82 per participant for counseling plus two weeks of nicotine replacement therapy versus $275.40 for counseling plus eight weeks of nicotine replacement therapy. The average costs per quit were estimated to be $1,156 for two weeks of nicotine replacement therapy and $1,405 for eight weeks of therapy, with an incremental cost effectiveness of $2,068.

"In summary, these results provide strong support for providing eight weeks of nicotine patches for uninsured callers to a state quitline," the study authors concluded.

The analysis was published in the August edition of the American Journal of Preventive Medicine.

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