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Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services

Buller, David B. PhD; Halperin, Abigail MD, MPH; Severson, Herbert H. PhD; Borland, Ron PhD; Slater, Michael D. PhD; Bettinghaus, Erwin P. PhD; Tinkelman, David MD; Cutter, Gary R. PhD; Woodall, William Gill PhD

Journal of Public Health Management and Practice: March/April 2014 - Volume 20 - Issue 2 - p E7–E15
doi: 10.1097/PHH.0b013e3182a0b8c7
Original Articles

Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit.

Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population.

Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed.

Design: Smokers were enrolled in a pretest-posttest trial, and randomized to 1 of 3 cessation services.

Setting: Trial delivering counseling services by self-help booklet, telephone quit lines, or online expert system in the 48 continental United States.

Intervention: Smokers could request a free 2-week course of nicotine replacement therapy (NRT) patches from the project.

Main Outcome Measure: Follow-up surveys at 12 and 26 weeks assessed smoking abstinence, use of NRT, counseling, and other cessation medications, and smoking-related variables.

Results: Overall, 69.0% of smokers reported using NRT (M = 3.2 weeks) at 12 weeks and 74.8% (M = 3.3 weeks) at 26 weeks. More smokers who were sent the free nicotine patches (n = 1695; 54.8%) reported using NRT than those who did not receive them (12 weeks: 84.3% vs 41.9%, P < .001; 26 weeks: 87.6% vs 51.1%, P < .001). The use of NRT was associated with greater smoking abstinence at 12 weeks (P < .001) and 26 weeks (P < .05), especially if used for more than 2 weeks (P < .001). Smokers assigned to a self-help booklet or cessation Web site and heavier smokers were most likely to use NRT (P < .05), whereas those reporting marijuana use and binge drinking used NRT less (P < .05).

Conclusions: Many young adults were willing to try NRT, and it appeared to help them quit in the context of community-based cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking.

This article describes the effect of nicotine replacement therapy (NRT) on quitting by young adults in a trial comparing cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking.

Klein Buendel, Inc, Golden, Colorado (Drs Buller and Bettinghaus); Department of Family Medicine, University of Washington, Seattle (Dr Halperin); Oregon Research Institute, Eugene (Dr Severson); Cancer Council Victoria, Carlton South, Victoria, Australia (Dr Borland); School of Communication, Ohio State University, Columbus (Dr Slater); National Jewish Health, Denver, Colorado (Dr Tinkelman); School of Public Health, University of Alabama at Birmingham (Dr Cutter); and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque (Dr Woodall).

Correspondence: David B. Buller, PhD, Klein Buendel, Inc, 1667 Cole Blvd, Ste 225, Golden, CO 80401 (

This project was supported by a grant from the National Cancer Institute (CA107444). The findings, views, and opinions expressed here are those of the authors.

Drs Buller and Bettinghaus are employed by Klein Buendel, Inc, a for-profit health communication research firm, and Klein Buendel, Inc, is owned by Dr Buller's spouse. Dr Bettinghaus is a member of the Board of Directors for Klein Buendel, Inc. Dr Cutter participated on data and safety monitoring committees for the following organizations focusing on medical research: Apotek, Biogen-Idec, Cleveland Clinic, Glaxo Smith Klein Pharmaceuticals, Gilead Pharmaceuticals, Modigenetech/Prolor, Merck/Ono Pharmaceuticals, Merck, Neuren, Revalesio, Sanofi-Aventis, Teva, Vivus, National Heart, Lung, and Blood Institute (Protocol Review Committee), National Institute on Neurological Disorders and Stroke, National Multiple Sclerosis Society, and National Institute on Child Health and Development (OPRU oversight committee). He has consulted, received speaking fees, or served on advisory boards for the following organizations: Alexion, Allozyne, Bayer, Celgene, Coronado Biosciences, Consortium of MS Centers (grant), Diogenix, Klein-Buendel Incorporated, Medimmune, Novartis, Nuron Biotech, Receptos, Spiniflex Pharmaceuticals, Teva pharmaceuticals. He is with the University of Alabama at Birmingham and is president of Pythagoras, Inc, a private consulting company located in Birmingham, Alabama. Drs Halperin, Severson, Borland, Slater, Tinkelman, and Woodall have no conflicts of interest.

© 2014 Lippincott Williams & Wilkins, Inc.