The role of nicotine replacement therapy in early quitting success.
BACKGROUND
Nicotine replacement therapy (NRT) is an effective but underutilized smoking cessation aid despite being available over the counter. This exploratory study examined whether voluntary early use of NRT predicted cessation in a self-initiated quit attempt better than other commonly studied variables.


METHODS
Data were collected from 99 adult smokers desiring to quit smoking in the near future over a 10-day baseline period prior to the implementation of a contingency management intervention. NRT use was neither encouraged nor discouraged during the study. Initial abstinence, biochemically verified using a criterion of CO level <4 ppm, was conceptualized in 2 ways: (a) any day of baseline abstinence and (b) the sum of baseline days abstinent. We examined the predictive value of NRT use as well as demographics, self-efficacy, motivational readiness, and nicotine dependence.


RESULTS
While greater self-efficacy was predictive of initial abstinence, NRT use was the most consistent predictor. The odds of abstaining at least 1 day during baseline were 16.8 times greater for those who used NRT on Day 1 than nonusers. Self-efficacy and "any baseline NRT use" contributed significant amounts of variance to the "sum of days abstinent," with the overall model explaining 29% of the variance (p < .001). The sum of baseline days of NRT use and use of NRT on Day 1 also predicted the "sum of days abstinent."


CONCLUSIONS
Given NRT's effectiveness, but underutilization in real-world settings, the data support the need for interventions or strategies encouraging people to use NRT in their quit attempts.
Amodei
Nancy
N
Departments of Pediatrics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA. amodei@uthscsa.edu
Lamb
R J
RJ
D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use*; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome
D009538:Nicotine