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Reach, Efficacy, and Cost‐effectiveness of Free Nicotine Medication Giveaway Programs

Cummings, K. Michael PhD, MPH; Fix, Brian MS; Celestino, Paula BS; Carlin-Menter, Shannon MS; O'Connor, Richard PhD; Hyland, Andrew PhD

Journal of Public Health Management & Practice: January/February 2006 - Volume 12 - Issue 1 - p 37–43
Article

In an effort to increase access to evidence-based smoking cessation therapies, regional tobacco control programs in New York State implemented different interventions to make free nicotine patches and gum available to smokers wishing to quit. In one region, eligible smokers were sent a voucher redeemable at a local pharmacy for a 2-week supply of either nicotine patches or gum. In other regions, smokers received either a 1-week supply or a 2-week supply of nicotine patches sent to their home. In New York City, eligible smokers received a 6-week supply of nicotine patches and a follow-up phone call. All of the programs utilized the state's Smokers' Quitline to screen and register eligible smokers for the free medication. The reach of the different programs was evaluated by computing the proportion of eligible smokers within a given area enrolled in the program and tracking call volume to the Quitline before, during, and after the free giveaway promotions. Efficacy was evaluated by a telephone follow-up survey of program participants conducted 4 months after enrollment to measure use of the medications and smoking behavior. The quit rate of program participants was contrasted with the quit rate computed from an earlier follow-up survey of Quitline callers who were not provided nicotine replacement therapy (NRT). Free nicotine patches or gum was sent to 40,090 smokers representing about 2.9 percent of eligible heavy smokers (10+ cigarettes per day) in the state. In each time period and location where free NRT was offered, call volume to the Quitline increased dramatically. Quit rates varied in relationship to the supply of NRT sent to participants, but in all cases was higher than the quit rate observed among smokers not sent NRT (21%–35% vs 12%). The offer of free NRT appears to be a cost-effective method to induce large numbers of smokers to make a quit attempt.

This study describes how different interventions were implemented in New York state to make free nicotine patches and gum available to smokers wishing to quit. The offer of free NRT appears to be a cost-effective method to induce large numbers of smokers to make a quit attempt.

Chairman, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York. (Cummings)

Research Affiliate, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York. (Fix)

coordinator New York State Smokers' Quitline, Roswell Park Cancer Institute, Buffalo. (Celestino)

Director of Evaluation, New York State Smokers' Quitline, Roswell Park Cancer Institute, Buffalo. (Carlin-Menter)

Assistant Research Scientist, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York. (O'Connor)

Associate Research Scientist, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York. (Hyland)

Corresponding author: K. Michael Cummings, PhD, MPH, Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 (e-mail: Michael.cummings@roswellpark.org).

Support for the various surveys described in this article was provided by the following: New York State Department of Health, Capital District Tobacco-Free Coalition, Erie/Niagara Tobacco Free Coalition, Rural Three for Tobacco Free Communities, Smoking and Health Action Coalition of Monroe County, Smoke Free NOW, Southern Tier Tobacco Action Coalition, and Tobacco Free Coalition of the Finger Lakes. The surveys reported in this article were conducted by the Center for Social Research at Buffalo State College under contract with Roswell Park Cancer Institute and Health.

© 2006 Lippincott Williams & Wilkins, Inc.