Using a quitline plus low-cost nicotine replacement therapy to help disadvantaged smokers to quit

Area of Science:

• Public Health
• Behavioral Science
• Addiction Medicine

Background:

• Low-income smokers face significant barriers to smoking cessation.
• Standard quitline services may not adequately reach or engage this demographic.
• Nicotine replacement therapy (NRT) is a proven aid for smoking cessation.

Purpose of the Study:

• To evaluate the effectiveness of subsidised nicotine replacement therapy (NRT) as an adjunct to standard quitline services for motivating low-income smokers to attempt quitting.
• To assess the recruitment and engagement rates of low-income smokers when offered subsidised NRT.
• To compare smoking cessation outcomes between low-income smokers receiving NRT and standard care.

Main Methods:

• A real-world trial involving low-income smokers recruited via mail or newspaper flyers.
• An intervention group received standard quitline counselling plus heavily subsidised NRT.
• A comparison group received standard quitline counselling only. Follow-up occurred at 3, 6, and 12 months.

Main Results:

• Subsidised NRT more than doubled recruitment of low-income smokers compared to cessation services alone (1000 vs. 377).
• Intervention group participants had higher nicotine dependence but also higher quit attempt rates (73.5% vs. 61.0%).
• Unadjusted quit rates were higher in the intervention group at 3 and 6 months, though not significant at 12 months.

Conclusions:

• Subsidised NRT is an effective strategy for engaging disadvantaged smokers with quitline services.
• Low-income smokers utilizing quitline services, with or without subsidised NRT, achieve cessation outcomes comparable to general "mainstream" smoker populations.
• Targeted interventions, like subsidised NRT, can improve access and outcomes for vulnerable smoking populations.