Nicotine replacement therapy in a group model HMO

To examine patient response to a smoking cessation program that combined a nicotine replacement system (patch) with telephone support.

Randomized trial.

A large Midwestern HMO. PARTICIPANTS. Five hundred and nine smokers who attended orientation sessions where an overview of the study and the use of the nicotine patch was presented.

All subjects received a prescription for a nicotine replacement patch (Prostep, Lederle Laboratories, Wayne, NJ). Participants were randomly assigned to one of three intervention groups. Group I participants (n = 166) received no additional support. Group II participants (n = 167) were registered with a 24-hour telephone hotline. Group III participants (n = 167) were registered with the 24-hour telephone hotline and received four follow-up telephone calls from health educators.

The primary outcome measure was smoking cessation. Subject satisfaction with study components was also evaluated.

Overall, there was no significant difference by group in smoking cessation rates: 20% of patients in all three groups were smoke-free after 12 months. Few patients (1%) used the telephone hotline. The telephone follow-up did not have an impact on cessation rates, and most patients (92%) reported that the orientation session was useful.

The study experience has helped the HMO evaluate various study components and has had an impact on currently used telephone intervention strategies and educational materials.