Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction
Abstract Background Large-scale distribution efforts of free nicotine replacement therapy (NRT) have been documented to be cost-effective interventions for increasing smoking quit rates. However, despite nearly a dozen studies evaluating their effectiveness, none have examined whether free NRT provi...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-017-4548-5 |
| _version_ | 1811281896822276096 |
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| author | Vladyslav Kushnir Beth A. Sproule John A. Cunningham |
| author_facet | Vladyslav Kushnir Beth A. Sproule John A. Cunningham |
| author_sort | Vladyslav Kushnir |
| collection | DOAJ |
| description | Abstract Background Large-scale distribution efforts of free nicotine replacement therapy (NRT) have been documented to be cost-effective interventions for increasing smoking quit rates. However, despite nearly a dozen studies evaluating their effectiveness, none have examined whether free NRT provision promotes further primary care help-seeking and the impact that it may have on cessation efforts. Methods In the context of a randomized controlled trial, a secondary analysis was conducted on 1000 adult regular smokers randomized to be mailed a 5-week supply of nicotine patches or to a no intervention control group. Recipients and users of free nicotine patches at an 8 week follow-up were successfully case matched to controls based on age, gender, baseline level of nicotine dependence and intent to quit (n = 201 per group). Differences in physician interaction between the two groups were evaluated at both 8 week and 6 month follow-ups. The impact of physician interaction on self-reported smoking abstinence at each follow-up was also examined. Results Although no differences in physician interaction were noted between groups at the 8 week follow-up, at the 6 month follow-up, nicotine patch users reported greater frequency of discussing smoking with their physician (43.9%), as compared to the control group (30.3%) (p = 0.011). Across both groups, over 90% of those that discussed smoking with a physician were encouraged to quit and approximately 70% were provided with additional support. Separate ANOVAs revealed no significant impact of physician interaction on cessation (p > 0.05), regardless of group or follow-up period, however, at the 6 month follow-up, nicotine patch users who discussed cessation with a physician had made serious quit attempts at significantly greater rates (72.6%), compared to controls (49.1%) (p = 0.007). Conclusions Irrespective of group, the majority of smokers in the present study did not discuss cessation with their physician. Recipients and users of nicotine patches however, were more likely to discuss smoking with their physician, suggesting that the provision of free NRT particularly to those who are likely to use it may facilitate opportunities for benefits beyond the direct pharmacological effects of the medication. Trial registration clinicaltrials.gov , NCT01429129 . Registered: 2 September 2011. |
| first_indexed | 2024-04-13T01:41:55Z |
| format | Article |
| id | doaj.art-5960bb93e3f0460f86e59d46fb826108 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-13T01:41:55Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-5960bb93e3f0460f86e59d46fb8261082022-12-22T03:08:09ZengBMCBMC Public Health1471-24582017-07-011811910.1186/s12889-017-4548-5Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interactionVladyslav Kushnir0Beth A. Sproule1John A. Cunningham2Centre for Addiction and Mental HealthCentre for Addiction and Mental HealthCentre for Addiction and Mental HealthAbstract Background Large-scale distribution efforts of free nicotine replacement therapy (NRT) have been documented to be cost-effective interventions for increasing smoking quit rates. However, despite nearly a dozen studies evaluating their effectiveness, none have examined whether free NRT provision promotes further primary care help-seeking and the impact that it may have on cessation efforts. Methods In the context of a randomized controlled trial, a secondary analysis was conducted on 1000 adult regular smokers randomized to be mailed a 5-week supply of nicotine patches or to a no intervention control group. Recipients and users of free nicotine patches at an 8 week follow-up were successfully case matched to controls based on age, gender, baseline level of nicotine dependence and intent to quit (n = 201 per group). Differences in physician interaction between the two groups were evaluated at both 8 week and 6 month follow-ups. The impact of physician interaction on self-reported smoking abstinence at each follow-up was also examined. Results Although no differences in physician interaction were noted between groups at the 8 week follow-up, at the 6 month follow-up, nicotine patch users reported greater frequency of discussing smoking with their physician (43.9%), as compared to the control group (30.3%) (p = 0.011). Across both groups, over 90% of those that discussed smoking with a physician were encouraged to quit and approximately 70% were provided with additional support. Separate ANOVAs revealed no significant impact of physician interaction on cessation (p > 0.05), regardless of group or follow-up period, however, at the 6 month follow-up, nicotine patch users who discussed cessation with a physician had made serious quit attempts at significantly greater rates (72.6%), compared to controls (49.1%) (p = 0.007). Conclusions Irrespective of group, the majority of smokers in the present study did not discuss cessation with their physician. Recipients and users of nicotine patches however, were more likely to discuss smoking with their physician, suggesting that the provision of free NRT particularly to those who are likely to use it may facilitate opportunities for benefits beyond the direct pharmacological effects of the medication. Trial registration clinicaltrials.gov , NCT01429129 . Registered: 2 September 2011.http://link.springer.com/article/10.1186/s12889-017-4548-5Smoking cessationNicotine replacement therapyPrimary care physiciansTobaccoHealth professionals |
| spellingShingle | Vladyslav Kushnir Beth A. Sproule John A. Cunningham Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction BMC Public Health Smoking cessation Nicotine replacement therapy Primary care physicians Tobacco Health professionals |
| title | Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| title_full | Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| title_fullStr | Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| title_full_unstemmed | Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| title_short | Impact of large-scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| title_sort | impact of large scale distribution and subsequent use of free nicotine patches on primary care physician interaction |
| topic | Smoking cessation Nicotine replacement therapy Primary care physicians Tobacco Health professionals |
| url | http://link.springer.com/article/10.1186/s12889-017-4548-5 |
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