title: Impact on quit attempts of mailed general practitioner 'brief advice' letters plus nicotine replacement therapy vouchers.
abstract: OBJECTIVE
  To test whether a personalised letter from general practitioners advising their patients who are smokers to quit, together with an exchange card for one month of nicotine gum, prompts them to make quit attempts, is acceptable and feasible.
  
  
  METHODS
  Non-randomised before-after ecological study involving general practices in Auckland, New Zealand. Personalised letters with exchange cards for four weeks of nicotine gum were sent to 831 patients within a single Auckland health board area who were recorded as current smokers on their general practitioners files. The comparison group was the population in another Auckland health board area. We measured calls to Quitline and vouchers redeemed at pharmacies from both areas before and after the intervention. Follow-up surveys of recipients and general practitioners assessed acceptability.
  
  
  RESULTS
  Quitline calls from baseline to the end of the intervention from the intervention district compared with a comparison district were not significantly higher (5%, 95% CI -2-12%, p = 0.195), but nicotine replacement therapy (NRT) voucher redemptions were significantly higher (9%, 95% CI 3-16%, p = .005). Almost 9% of the exchange cards were redeemed for NRT. Despite initial difficulties in accurately identifying smokers from their records, responding GPs found the strategy very acceptable.
  
  
  CONCLUSIONS
  The strategy shows potential as a simple way to increase the number of smokers making supported quit attempts through primary care. In the light of the urgent need to increase cessation rates, a randomised trial of this promising approach is warranted.
authors.affiliation: Auckland Tobacco Control Research Centre, School of Population Health, The University of Auckland, Auckland, New Zealand.
authors.forename: Donna
authors.initials: D
authors.lastname: Watson
authors.forename: Chris
authors.initials: C
authors.lastname: Bullen
authors.forename: Marewa
authors.initials: M
authors.lastname: Clover
authors.forename: Hayden
authors.initials: H
authors.lastname: McRobbie
authors.forename: Varsha
authors.initials: V
authors.lastname: Parag
authors.forename: Natalie
authors.initials: N
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002638:Chewing Gum; D015709:Correspondence as Topic; D037001:Directive Counseling / Q000379:methods; D005194:Family Practice; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D012657:Self-Help Groups / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D002638:Chewing Gum; D018722:Nicotinic Agonists