title: Randomised trial of two nicotine patch protocols distributed through a state quitline.
abstract: BACKGROUND
  Most telephone quitlines provide free nicotine replacement therapy (NRT). An 8-week course is recommended, but few users complete it. Information is needed to help quitlines distribute NRT cost-effectively.
  
  
  METHODS
  Randomised two-group trial.
  
  
  METHODS
  Colorado QuitLine callers who smoked 16-20 cigarettes per day at enrolment and who were eligible for and agreed to receive free NRT.
  
  
  METHODS
  Provision of 4-week versus 8-week NRT supply; the 8-week supply was shipped in halves and required participants to request the second half (split-shipment protocol). Enrolment occurred during March 2010-February 2011, follow-up concluded in November 2011, and analysis was performed in 2012.
  
  
  METHODS
  Point abstinence (7 and 30 day) and prolonged abstinence (6 month) from tobacco use.
  
  
  RESULTS
  Overall, 1495 study participants were enrolled and 57.7% completed follow-up. Abstinence rates did not differ significantly between study conditions: 13.8% versus 12.4% in 4-week versus 8-week arms, respectively, (30-day point abstinence, non-respondents treated as smokers). NRT duration was similar in both groups, due in part to purchase of additional patches in the 4-week group. About one-third of the 8-week group requested the full 8-week supply and had higher abstinence rates. Cost per quit was lower in the 4-week (compared to 8-week) group.
  
  
  CONCLUSIONS
  A randomised trial did not find worse cessation outcomes among quitline users who received half the minimum recommended course of NRT, but offering the full recommended course using a split-shipment protocol may be reasonably cost-effective and supportive of NRT adherers.
  
  
  BACKGROUND
  NCT01889771.
authors.affiliation: Mercy Family Medicine, Mercy Regional Medical Center, Centura Health, Durango, Colorado, USA.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Burns
authors.affiliation: Community Properties of Ohio Management Services, Columbus, Ohio, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Hood
authors.affiliation: Colorado Department of Public Health and Environment, Prevention Services Division, Denver, Colorado, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Goforth
authors.affiliation: Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA University of Colorado Cancer Center, Aurora, Colorado, USA.
authors.forename: Arnold H
authors.initials: AH
authors.lastname: Levinson
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D033161:Government Regulation; D006801:Humans; D009111:Local Government; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000191:economics; D018722:Nicotinic Agonists / Q000008:administration & dosage* / Q000191:economics; D011314:Preventive Health Services / Q000191:economics / Q000379:methods*; D012907:Smoking / Q000009:adverse effects / Q000191:economics / Q000523:psychology; D016540:Smoking Cessation / Q000191:economics / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D013997:Time Factors; D061485:Tobacco Use Cessation Devices / Q000191:economics; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D057968:Transdermal Patch; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine
keywords: Cessation; Economics; Health Services