Simple changes — nicotine drug, phone calls for reassurance — found to help more smokers stop
A free supply of nicotine replacement medication and a handful of automated phone calls made smokers who wanted to quit much more likely to succeed, according to results of a clinical trial published on Tuesday in the Journal of the American Medical Association.
The researchers who designed the trial said they were looking for a simple and inexpensive way to aid smokers who were motivated to kick the habit. They estimated that once their 90-day program was set up, it could be maintained at a cost of less than $1,000 per quitter.
The study involved 397 smokers who were admitted to Massachusetts General Hospital in Boston between August 2010 and November 2012. Like all hospitals in the U.S., Massachusetts General is a smoke-free facility, and smokers treated there are offered nicotine replacement therapy to help them deal with their withdrawal symptoms. Patients who want to remain smoke-free after they are discharged can get help from counselors in the hospital's Tobacco Treatment Service.
For the trial, 199 patients received the usual care — a recommendation for specific tobacco cessation medication that could be prescribed by a doctor upon discharge and the number for a toll-free quit line. The same number got “sustained care,” which included a free, 30-day supply of medication that was chosen by the patient and his or her counselor. The medication could be refilled twice during the trial. Patients getting “sustained care” also got five automated phone calls that encouraged them to keep taking their medication, offered advice to help them stay smoke-free and identified those who needed to talk to the counselor one on one.
After six months, 27 percent of the patients who got the extra help told researchers that they had not smoked anything (including electronic cigarettes) in the previous week. The researchers didn't just take their word for it; they used a saliva test to check for a chemical called cotinine (which the body produces as it metabolizes nicotine) and they tested for carbon monoxide in exhaled air. These biochemical tests confirmed that 26 percent of the former smokers had abstained for at least seven days.
By comparison, 16 percent of the patients who got the usual care said they had not smoked for the previous week, and 15 percent were deemed smoke-free by a biochemical test.
Overall, the patients who got “sustained care” were 70 percent to 71 percent more likely to be non-smokers after six months than the patients who got the usual care, the researchers found.
The patients who enrolled in the study were not just casual smokers — before they wound up in the hospital, they smoked 16.7 cigarettes a day, on average. The 45 percent of study participants who were hospitalized for a smoking-related disease were just as likely to benefit from the extra help as the 55 percent of patients who wound up in the hospital for other reasons.
However, the researchers found that the program was most beneficial for the African-Americans, Latinos, Asian Americans and Native Americans in the study. Among these patients, 38 percent who got the extra help were still not smoking after six months, compared with only 6 percent who received the usual care.
The researchers said that the biggest difference between the two groups is that patients who got “sustained care” used nicotine replacement therapy longer than patients who didn't. For instance, 48 percent of patients in the usual care group used some form of NRT (such as nicotine patches, gum or lozenges) for only two weeks or less. By comparison, 61 percent of patients who tried the “sustained care” stuck with the medication for eight weeks or longer, according to the study.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Reagan shooter Hinckley closer to permanent freedom
- Baltimore investigates death of man in police custody
- U.S. moms typically space pregnancies by 2.5 years
- U.S. attorney general nominee Lynch vote likely this week, U.S. senator says
- Service marks 20 years since Oklahoma City bombing
- Cardinal Francis George of Chicago dead at 78
- Gas pipeline explosion probed at California gun range
- Keystone pipeline project gains favor among nearby liberals, study shows
- New York City rent increases oust small retailers
- Shuster admits to ‘personal relationship’ with airline industry lobbyist
- Federal judge who blocked Obama immigration order painted as unbiased