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Free, easy and effective: how young adults used 8 weeks of mailed nicotine patches and to what effect

Published online by Cambridge University Press:  03 November 2020

Kelli-an Lawrance*
Affiliation:
Department of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
Amanda Kirkwood
Affiliation:
Leave The Pack Behind, Brock University, St. Catharines, Ontario, Canada
Heather Travis
Affiliation:
Leave The Pack Behind, Brock University, St. Catharines, Ontario, Canada
Peter Selby
Affiliation:
Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
*
Author for correspondence: Kelli-an Lawrance, E-mail: klawrance@brocku.ca

Abstract

Introduction

Research shows the mass distribution of free nicotine replacement therapy (NRT) is a high-impact, population-level strategy for smoking cessation; but underrepresentation of younger, and/or lighter, smokers challenges generalisability of findings to young adult smokers.

Aims

This naturalistic study examined how and with what effect young adult smokers used free nicotine patches provided through a mass mailout programme.

Methods

In total, 5,025 eligible 18–29 year-old smokers who accessed an online ordering platform received self-help materials and an 8-week course of patches matched to their consumption level (<10 cigarettes per day (cpd); ≥10 cpd). No other behavioural support occurred. Whether participants used patches correctly and achieved 30-day continuous abstinence at 6-month follow-up were assessed.

Results

Among 694 participants with complete data: 89% used some patches; 8% used the patches correctly for 8 weeks; 31.0% (95% confidence interval (CI) = 27.6, 34.7) achieved abstinence. Adjusted logistic regression analysis showed the highest odds of abstinence was associated with the correct use of patches (odds ratio = 2.8, 95% CI = 1.5, 5.1).

Conclusions

Mass distribution of free patches may be an effective public health measure for supporting younger, lighter smokers to attempt cessation, reduce consumption, or achieve abstinence. Emphasising why and how to use NRT for the entire treatment course may enhance outcomes.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Arnett, J. (2000). Optimistic bias in adolescent and adult smokers and nonsmokers. Addictive Behaviors, 25(4), 625632.10.1016/S0306-4603(99)00072-6CrossRefGoogle ScholarPubMed
Babb, S., Malarcher, A., Schauer, G., Asman, K., & Jamal, A. (2017). Quitting smoking among adults – United States, 2000–2015. MMWR Morbidity and Mortality Weekly Report, 65, 14571464. doi:http://dx.doi.org/10.15585/mmwr.mm6552a1.CrossRefGoogle ScholarPubMed
Balmford, J., Borland, R., Hammond, D., & Cummings, M. (2011). Adherence to and reasons for premature discontinuation from stop-smoking medications: Data from the ITC four-country survey. Nicotine & Tobacco Research, 13(2), 94102.10.1093/ntr/ntq215CrossRefGoogle ScholarPubMed
Buller, D. B., Halperin, A., Severson, H. H., Borland, R., Slater, M. D., Bettinghaus, E. P., … Woodall, W. G. (2014). Effect of nicotine replacement therapy on quitting by young adults in a trial comparing cessation services. Journal of Public Health Management and Practice, 20(2), E7E15. doi:10.1097/PHH.0b013e3182a0b8c7.CrossRefGoogle Scholar
Burns, E. K., Hood, N. E., Goforth, E., & Levinson, A. H. (2016). Randomised trial of two nicotine patch protocols distributed through a state quitline. Tobacco Control, 25, 218223.10.1136/tobaccocontrol-2014-051843CrossRefGoogle ScholarPubMed
Bush, T. M., McAfee, T., Deprey, M., Mahoney, L., Fellows, J. L., McClure, J., & Cushing, C. (2008). The impact of a free nicotine patch starter kit on quit rates in a state quit line. Nicotine & Tobacco Research, 10(9), 15111516. doi:10.1080/14622200802323167.CrossRefGoogle Scholar
Campbell, S. L., Lee, L., Haugland, C., Helgerson, S. D., & Harwell, T. S. (2008). Tobacco quitline use: Enhancing benefit and increasing abstinence. American Journal of Preventive Medicine, 38(4),386–368. doi:10.1016/j.amepre.2008.06.032.CrossRefGoogle Scholar
Cantrell, J., Hair, E. C., Smith, A., Bennett, M., Miller Rath, J., Thomas, R. K., … Vallone, D. (2018). Recruiting and retaining youth and young adults: Challenges and opportunities in survey research for tobacco control. Tobacco Control, 27, 147154. doi:10.1136/tobaccocontrol-2016-053504.CrossRefGoogle Scholar
Cha, S., Ganz, O., Cohn, A., Ehkle, S., & Graham, A. (2017). Feasibility of biochemical verification in a web-based smoking cessation study. Addictive Behaviors, 73, 204208. doi:10.1016/j.addbeh.2017.05.020.CrossRefGoogle Scholar
Cummings, K. M., Fix, B., Celestino, P., Carlin-Menter, S., O'Connor, R., & Hyland, A. (2006). Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs. Journal of Public Health Management and Practice, 12(1), 3743. doi:10.1097/00124784-200601000-00009.CrossRefGoogle ScholarPubMed
Cummings, K. M., Fix, B. V., Celestino, P., Hyland, A., Mahoney, M., Ossip, D. J., & Bauer, U. (2010). Does the number of free nicotine patches given to smokers calling a quitline influence quit rates: Results from a quasi-experimental study. BMC Public Health, 10(1) 181. http://www.biomedcentral.com/1471-2458/10/181.10.1186/1471-2458-10-181CrossRefGoogle ScholarPubMed
Cummings, K. M., Hyland, A., Carlin-Menter, S., Mahoney, M. C., Willett, J., & Juster, H. R. (2011). Costs of giving out free nicotine patches through a telephone quit line. Journal of Public Health Management Practice, 17(3), E16E23. doi:10.1097/PHH.0b013e3182113871.CrossRefGoogle ScholarPubMed
Cunningham, J. A., Kushnir, V., Selby, P., Tyndale, R. F., Zawertailo, L., & Leatherdale, S. (2016). Effect of mailing nicotine patches on tobacco cessation among adult smokers: A randomized clinical trial. JAMA Internal Medicine, 176(2), 184190. doi:10.1001/jamainternmed.2015.7792.CrossRefGoogle ScholarPubMed
Dillman, D. A., Phelps, G., Tortora, R., Swift, K., Kohrell, J., Berck, J., & Messer, B. L. (2009). Response rate and measurement differences in mixed-mode surveys using mail, telephone, interactive voice response (IVR) and the internet. Social Science Research, 38(1), 118. doi:10.1016/j.ssresearch.2008.03.007.CrossRefGoogle Scholar
Gajic, A., Cameron, D., & Hurley, J. (2012). The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey. European Journal of Health Economics, 13, 789799. doi:10.1007/s10198-011-0332-0.CrossRefGoogle ScholarPubMed
Göritz, A. S. (2006). Incentives in web studies: Methodological issues and a review. International Journal of Internet Science, 1(1), 5870.Google Scholar
Hair, E., Bennett, M., Williams, V., Johnson, A., Rath, J., Cantrell, J., … Valone, D. (2017). Progression to established patterns of cigarette smoking among young adults. Drug & Alcohol Dependence, 177, 7783. doi:10.1016/j.drugalcdep.2017.03.040.CrossRefGoogle ScholarPubMed
Hartmann-Boyce, J., Hong, B. S., Livingstone-Banks, J., Wheat, H., & Fanshawe, T. R. (2019). Additional behavioral support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews, 6(CD009670). doi:10.1002/14651858.CD009670.pub4.Google ScholarPubMed
Health Canada (2018). Canadian Tobacco, Alcohol and Drugs Survey. Detailed tables of the survey data. Table 4. Number of quit attempts in the past 12 months by age group and sex, daily smokers, age group, [2013], [2015], [2017]. Retrieved from https://www.canada.ca/en/health-canada/services/canadian-tobacco-alcohol-drugs-survey.html.Google Scholar
Health Canada (2019). Canadian Tobacco, Alcohol and Drugs (CTADS) Survey: 2017 detailed tables. Table 2. Smoking status by province, age group and sex, 2017. Retrieved from https://www.canada.ca/en/health-canada/services/canadian-tobacco-alcohol-drugs-survey/2017-summary/2017-detailed-tables.html#t2Google Scholar
Hedeker, D., Mermelstein, R. J., & Demirtas, H. (2007). Analysis of binary outcomes with missing data: Missing = smoking, last observation carried forward, and a little multiple imputation. Addiction, 102, 15641573. doi:10.1111/j.1360-0443.2007.01946.x.CrossRefGoogle Scholar
Hughes, J., Keely, J., Niaura, R., Ossip-Klein, D., Richmond, R., & Swan, G. (2003). Measures of abstinence in clinical trials: Issues and recommendations. Nicotine & Tobacco Research, 5(1), 1325. doi:10.1080/1462220031000070552.CrossRefGoogle ScholarPubMed
Jackson, D., White, I. R., Mason, D., & Sutton, S. (2014). A general method for handling missing binary outcome data in randomized controlled trials. Addiction, 109(12), 19861993. doi:10.1111/add.12721.CrossRefGoogle ScholarPubMed
Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., … Peto, R. (2013). 21st-century Hazards of smoking and benefits of cessation in the United States. New England Journal of Medicine, 368(4), 341350. doi:10.1056/NEJMsa1211128.CrossRefGoogle ScholarPubMed
Johnson, A. L., Villanti, A. C., Williams, V., Rath, J. M., Vallone, D. M., Abrams, D. B. (2018). Smoking trajectory classes and impact of social smoking identity in two cohorts of U.S. Young adults. Emerging Adulthood, 7(4), 258269. doi:10.1177/2167696818763949.CrossRefGoogle Scholar
Jolicoeur, D. G., Richter, K. P., Ahluwalia, J. S., Mosier, M. C., & Resnicow, K. (2003). Smoking cessation, smoking reduction, and delayed quitting among smokers given nicotine patches and a self-help pamphlet. Substance Abuse, 24(2), 101106. doi:10.1023/A:1023784615928.CrossRefGoogle Scholar
Krupski, L., Cummings, K. M., Hyland, A., Carlin-Menter, S., Toll, B. A., & Mahoney, M. C. (2013). Nicotine replacement therapy distribution to light daily smokers calling a quitline. Nicotine & Tobacco Research, 15(9), 15721577. doi:10.1093/ntr/ntt021.CrossRefGoogle ScholarPubMed
Kushnir, V., Sproule, B. A., & Cunningham, J. A. (2017). Mailed distribution of free nicotine patches without behavioral support: Predictors of use and cessation. Addictive Behaviors, 67, 7378. doi:10.1016/j.addbeh.2016.12.008.CrossRefGoogle ScholarPubMed
Lindson, N., Chepkin, S. C., Ye, W. Y., Fanshawe, T. R., Bullen, C., & Hartmann-Boyce, J. (2019). Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews, 4(CD013308). doi:10.1002/14651858.CD013308.Google ScholarPubMed
Livingstone-Banks, J., Ordóñez-Mena, J. M., & Hartmann-Boyce, J. (2019). Print-based self-help interventions for smoking cessation. Cochrane Database of Systematic Reviews 2019(1). Art. No.: CD001118. doi:10.1002/14651858.CD001118.pub4.Google Scholar
Masiero, M., Riva, S., Oliveri, S., Fioretti, C., & Pravettoni, G. (2018). Optimistic bias in young adults for cancer, cardiovascular and respiratory diseases: A pilot study on smokers and drinkers. Journal of Health Psychology, 23(5), 645656. doi:10.1177/1359105316667796.CrossRefGoogle ScholarPubMed
McAfee, T., Bush, T., Deprey, T. M., Mahoney, L. D., Zbikowski, S. M., Fellows, J. L., & McClure, J. B. (2008). Nicotine patches and uninsured quitline callers: A randomized trial of two versus eight weeks. American Journal of Preventive Medicine, 35(2), 103110. doi:10.1016/j.amepre.2008.04.017.Google ScholarPubMed
Miller, N., Frieden, T. R., Liu, S. Y., Matte, T. D., Mostashari, F., Deitcher, D. R., … Bassett, M. T. (2005). Effectiveness of a large-scale distribution programme of free nicotine patches: A prospective evaluation. Lancet, 365(9474), 18491854. doi:10.1016/S0140-6736(05)66615-9.CrossRefGoogle ScholarPubMed
Nelson, D. B., Partin, M. R., Fu, S. S., Joseph, A. M., & An, L. C. (2009). Why assigning ongoing tobacco use is not necessarily a conservative approach to handling missing tobacco cessation outcomes. Nicotine & Tobacco Research, 11, 7783. doi:10.1093/ntr/ntn013.CrossRefGoogle Scholar
Niaura, R. (2018). Communicating differences in tobacco product risks: Timing is of the essence. Addictive Behaviors, 76, 388389. doi:10.1016/j.addbeh.2017.01.028.CrossRefGoogle ScholarPubMed
Pirie, K., Peto, R., Reeves, G. K., Green, J., & Beral, V., & Million Women Study Collaborators. (2012). The 21st century hazards of smoking and benefits of stopping: A prospective study of one million women in the UK. Lancet, 381(9861), 133141. doi:10.1016/S0140-6736(12)61720-6.CrossRefGoogle ScholarPubMed
Reid, J. L., Harnmond, D., Rynard, V. L., & Burkhalter, R. (2015). Tobacco use in Canada: Patterns and trends, 2015 edition. Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo. Retrieved from https://uwaterloo.ca/tobacco-use-canada/sites/ca.tobacco-use-canada/files/uploads/files/tobaccouseincanada_2015_accessible_final-s.pdf.Google Scholar
Sinclair, M., O'Toole, J., Malawaraarachchi, M., & Leder, K. (2012). Comparison of response rates and cost-effectiveness for a community-based survey: Postal, internet and telephone modes with generic or personalised recruitment approaches. BMC Medical Research Methodology, 12(132), 1. doi:10.1186/1471-2288-12-132.CrossRefGoogle ScholarPubMed
SRNT Subcommittee on Biochemical Verification (2002). Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4(2), 149159. doi:10.1080/14622200210123581.CrossRefGoogle Scholar
Stead, L. F., Perera, R., Bullen, C., Mant, D., Hartmann-Boyce, J., Cahill, K., & Lancaster, T. (2012). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews, 11(CD000146). doi:10.1002/14651858.CD000146.pub4.Google ScholarPubMed
Swartz, S. H., Cowan, T. M., Klayman, J. E., Welton, M. T., & Leonard, B. A. (2005). Use and effectiveness of tobacco telephone counseling and nicotine therapy in Maine. American Journal of Preventive Medicine, 29(4), 288294. doi:10.1016/j.amepre.2005.06.015.CrossRefGoogle ScholarPubMed
Tinkelman, D., Wilson, S. M., Willett, J., & Sweeney, C.T. (2007). Offering free NRT through a tobacco quitline: Impact on utilisation and quit rates. Tobacco Control, 16(S1), s42s46. doi:10.1136/tc.2007.019919.CrossRefGoogle ScholarPubMed
Tong, E. K., Ong, M. K., Vittinghoff, E., & Perez-Stable, E. J. (2006). Nondaily smokers should be asked and advised to quit. American Journal of Preventive Medicine, 30, 2330. doi:10.1016/j.amepre.2005.08.048.CrossRefGoogle Scholar
Travis, H., & Lawrance, K. (2009). Randomized controlled trial examining the effectiveness of a tailored self-help smoking-cessation intervention for postsecondary smokers. Journal of American College Health, 57, 437444. doi:10.3200/JACH.57.4.437-444.CrossRefGoogle ScholarPubMed
Villanti, A. C., Niaura, R. S., Abrams, D. B., & Mermelstein, R. (2019). Preventing smoking progression in young adults: The concept of prevescalation. Prevention Science, 20(3), 377384. doi:10.1007/s11121-018-0880-y.CrossRefGoogle ScholarPubMed
Voci, S. C., Zawertailo, L. A., Hussain, S., & Selby, P. L. (2016). Association between adherence to free nicotine replacement therapy and successful quitting. Addictive Behaviors, 61, 2531. doi:10.1016/j.addbeh.2016.05.012.CrossRefGoogle ScholarPubMed
West, J. C., Villanti, A. C., Graham, A. L., Mays, D., Mermelstein, R. J., & Higgins, S. T. (2019). Tobacco use and cessation behaviors in young adults: 2016 National Health Interview Survey. American Journal of Public Health, 109(2), 296299. doi:10.2105/AJPH.2018.304815.CrossRefGoogle ScholarPubMed
Zawertailo, L., Dragonetti, R., Bondy, S. J., Victor, J. C., & Selby, P. L. (2013). Reach and effectiveness of mailed nicotine replacement therapy for smokers: 6-month outcomes in a naturalistic exploratory study. Tobacco Control, 22(3), e4. doi:10.1136/tobaccocontrol-2011-050303.CrossRefGoogle Scholar
Zhang, B., Cohen, J. E., Bondy, S. J., & Selby, P. L. (2015). Duration of nicotine replacement therapy use and smoking cessation: A population-based longitudinal study. American Journal of Epidemiology, 181(7), 513520. doi:10.1093/aje/kwu292.CrossRefGoogle ScholarPubMed
Zhu, S.-H., Sun, J., Hawkins, S., Pierce, J., & Cummins, S. (2003). A population study of low-rate smokers: Quitting history and instability over time. Health Psychology, 22, 245252. doi:10.1037/0278-6133.22.3.245.CrossRefGoogle ScholarPubMed