Evaluating the Effect of Access to Free Medication to Quit Smoking: A Clinical Trial Testing ...
Friday, July 11, 2014
Posted by: Natalia Gromov
Nicotine Tob Res. 2014 Jul;16(7):992-9. doi: 10.1093/ntr/ntu025.
Evaluating the Effect of
Access to Free Medication to Quit Smoking: A Clinical Trial Testing the Role of
Motivation.
Jardin BF, Cropsey KL,
Wahlquist AE, Gray KM, Silvestri GA, Cummings KM, Carpenter MJ.
Although the majority of smokers are ambivalent about quitting, few treatments
specifically target smokers lacking motivation to quit in the near future. Most
existing interventions are instead predicated on the belief that active
treatments should only be distributed to smokers interested in quitting, a
largely untested assumption. METHODS:
In the current clinical trial (N = 157), motivated smokers
wanting to quit in the next 30 days were given a 2-week nicotine replacement
therapy (NRT) sample and a referral to a quitline (Group MNQ), while
unmotivated smokers were randomized to receive the same treatment (Group UNQ)
or a quitline referral only (Group UQ). Participants were tracked via telephone
for 3 months to assess quitting behaviors and smoking reduction. RESULTS: Groups
significantly differed across all comparisons with regard to incidence of any
quit attempt (MNQ: 77%, UNQ: 40%, UQ: 18%, p < .05) and any 24-hr quit
attempts (62%, 32%, 16%, p < .05). Clinically meaningful differences emerged
in the rates of floating (19%, 17%, 6%) and point prevalence abstinence (17%,
15%, 5%). Compared to participants in Group UQ (11%), a greater proportion of
participants in Group MNQ (48%, p = .01) and Group UNQ (31%, p = .01) reduced
their daily cigarette consumption by at least half. Proxy measures of cessation
readiness (e.g., motivation) favored participants receiving active forms of
treatment. CONCLUSIONS: Providing
NRT samples engaged both motivated and unmotivated smokers into the quitting
process and produced positive changes in smoking outcomes. This suggests that
motivation should not be considered a necessary precondition to receiving
treatment.
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