Nicotine replacement therapy sampling via primary care: Methods from a pragmatic cluster randomized clinical trial

Area of Science:

• Public Health
• Clinical Trials
• Tobacco Cessation

Background:

• Primary care settings are crucial touchpoints for engaging smokers in cessation.
• Current brief physician advice (5As/AAR model) shows limited population impact due to inconsistent administration.
• Nicotine replacement therapy (NRT) sampling offers a simple, brief addition to primary care interventions.

Purpose of the Study:

• To assess the comparative effectiveness of standard care versus standard care plus NRT sampling.
• To evaluate the impact of NRT sampling on smoking cessation, quit attempts, and evidence-based treatment uptake.

Main Methods:

• A comparative effectiveness trial was conducted in a network of South Carolina primary care clinics.
• Smokers were recruited between July 2014 and December 2017.
• Interventions were randomized, with centrally coordinated phone follow-ups for six months.

Main Results:

• Twenty-two clinics participated, with varying patient census and provider numbers.
• Average patient age was 52.9 years, with smoking prevalence ranging from 10.6% to 28.5% across clinics.

Conclusions:

• Enhancing primary care interventions is key to improving population quit rates.
• Methodological considerations for future primary care cessation trials are discussed.