Effectiveness of Delivering Free Nicotine Replacement Therapy Sample at Outdoor Smoking Hotspots on Quit Attempts: A Pilot Randomized Controlled Trial

Abstract

Background and Objectives: We have shown that promoting smoking cessation at outdoor smoking hotspots is feasible and efficacious to recruit smokers for further smoking cessation interventions. We examined whether a free 1-week nicotine replacement therapy (NRT) sample would motivate adult smokers, who were recruited at smoking hotspots, to use NRT and quit. Methods: This was a pilot single-blinded, 2-group (1:1) randomized controlled trial on adult smokers recruited at outdoor smoking hotspots from July 2015 to January 2016. We trained university students to recruit smokers and deliver interventions. Smokers who smoked 10 or more cigarettes per day and deemed appropriate for using NRT were individually randomized to receive 1-week free NRT gum or patch, and a brief advice on using NRT (intervention, n=50), or just an advice to purchase on their own or obtain from existing smoking cessation services (control, n=50). The primary outcome was self-reported quit attempts (no smoking for at least 24 hours) in the past 30 days at 1- and 3-month telephone follow-up. Results: The intervention group had a greater rate of using NRT by the first month (38% versus 6%, Crude prevalence ratio (PR) = 6.33, 95% CI 2.00-20.18) and quit attempts than the control group at 1- (14% versus 10%; PR = 1.40, 95% CI 0.47-4.14) and 3-month follow-up (20% versus 8%; PR = 2.50, 95% CI 0.83-7.49). Within the intervention group, use of NRT at 1-month follow-up predicted quit attempts at 3-month follow-up (42% versus 16%, PRadj = 2.61, 95% CI 0.99-6.89). The 7-day point prevalence of abstinence at 6-month follow-up in the two groups was the same (8%). Conclusions: This study has shown proof-of-concept evidence that 1-week free NRT sample could motivate NRT use and quit attempts in the adult smokers. Larger trials with more strategies for long-term NRT use and quitting outcomes are warranted.