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Costs of Giving Out Free Nicotine Patches Through a Telephone Quit Line

Cummings, K. Michael PhD, MPH; Hyland, Andrew PhD; Carlin-Menter, Shannon PhD; Mahoney, Martin C. PhD, MD; Willett, Jeffrey PhD; Juster, Harlan R. PhD

Journal of Public Health Management and Practice: May/June 2011 - Volume 17 - Issue 3 - p E16–E23
doi: 10.1097/PHH.0b013e3182113871
Original Article

Background: Many telephone quit lines provide free nicotine replacement therapy (NRT) to smokers who are trying to stop smoking. However, providing free NRT to smokers can be costly.

Objective: To compare NRT usage patterns, quit rate, and costs of giving smokers calling a telephone quit line different amounts of free NRT.

Design: A 3-group randomized trial was conducted.

Setting and Participants: A total of 2806 adult smokers of 10+ cigarettes per day who called the New York State Smokers' Quit Line (NYSSQL) were sent different amounts of nicotine patches for free as follows: (1) a 2-week supply of nicotine patches, (2) a 4-week supply, and (3) a 6-week supply. In addition, all study participants received a free stop smoking guide plus 1 proactive follow-up call attempt conducted 2 weeks after initially contacting the NYSSQL. Of the 2806 enrolled participants, 1682 completed the 7-month follow-up to assess their use of the NRT sent to them and smoking status.

Main Outcome Measures: Nicotine patch usage, quit rates, reductions in cigarette consumption, and cost-effectiveness measures.

Results: Most respondents (85%) reported using the nicotine patches sent to them, although the amount used varied in direct proportion to the amount sent. The 7- and 30-day nonsmoker prevalence rates measured at 7-month follow-up did not differ significantly between the 3 groups. The cost per attributable quit was also not significantly different between the 3 groups.

Conclusion: Sending out more than a free 2-week supply of patches to smokers who contact a quit line is no more effective in achieving smoking cessation than sending just 2 weeks of patches.

This study describes a 3-group randomized trial to compare NRT usage patterns, quit rate, and costs of giving smokers calling a telephone quit line different amounts of free NRT.

Department of Health Behavior, Roswell Park Cancer Institute (Drs Cummings and Hyland), New York State Smokers' Quit Line, Roswell Park Cancer Institute (Drs Carlin-Menter and Mahoney), Buffalo, New York; and New York State Tobacco Control Program (Dr Willett) and New York State Department of Health, Tobacco Surveillance, Evaluation, & Research (Dr Juster), Albany.

Correspondence: K. Michael Cummings, PhD, MPH, Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton St, Buffalo, NY 14263 (

Authors contributions are as follows: conception and design, K.M.C., A.H., S.C.M., M.H., H.J.; acquisition of data, A.H., S.C.M., J.W.; data analysis and interpretation, K.M.C., A.H., S.C.M., M.C.M.; and drafting the article and/or revising it critically for important intellectual content, K.M.C., A.H., S.C.M., M.C.M., J.W., H.J.

Funding for this study was provided by the New York State Department of Health.

© 2011 Lippincott Williams & Wilkins, Inc.