Smoking Cessation Clinical Trial
Official title:
Long-term Effectiveness of Mailed Nicotine Replacement Therapy: A 5-year Follow-up
This study will perform a 5-year follow-up survey of participants in a randomized controlled trial that evaluated the effectiveness of providing 5 weeks of free NRT (in the form of the nicotine patch) by expedited postal mail without behavioural assistance to regular adult smokers recruited across Canada interested in receiving it (clinicaltrials.gov Identifier: NCT01429129).
Our group recently completed a randomized controlled trial evaluating the efficacy of
providing 5 weeks of free NRT (in the form of the nicotine patch) by expedited postal mail
without behavioural assistance to regular adult smokers recruited across Canada interested in
receiving it (clinicaltrials.gov Identifier: NCT01429129). The findings revealed that the
provision of free nicotine patches via mail resulted in more than a doubling of 30-day
abstinence quit rates at a six-month follow-up compared to the no intervention control group
(7.6% versus 3.0%; odds ratio of 2.65). While this trial provided evidence for the
effectiveness of nicotine patches as a tobacco cessation aid in real world settings, the
findings speak only to the short-term effectiveness of NRT. As evidence for NRT effectiveness
has been largely restricted to a final follow-up of 6-12 months after the start of treatment,
and relapse to smoking is known to occur beyond this period, it is important to evaluate
whether the net benefit of NRT in naturalistic settings can be maintained long-term.
Employing a survey research call centre, trained interviewers will contact participants in
the original randomized controlled trial, 5 years post-enrollment. A total of 924 subjects
will be eligible to be contacted, however intent-to-treat analyses will evaluate outcomes
based on all 1000 participants randomized to condition in the original trial. In this 5-year
follow-up survey, interviewers will first assess participants' smoking status, the number of
cigarettes smoked per day and their level of nicotine dependence. Participants reporting not
currently smoking will be asked whether they have smoked tobacco, even a puff, in the last 30
days (primary outcome measure: abstinence using 30 day point prevalence), past 6 months
(secondary outcome measure: prolonged 6-month abstinence), and since the last follow-up
survey (secondary outcome measure: > 4 year continuous abstinence). Interviewers will be
blind to experimental condition at the time the primary outcome measure will be assessed. The
survey component of the proposed study will be conducted over a 2 year period to coincide
with the duration of subject recruitment in the original trial. The primary hypothesis is
that subjects who received nicotine patches at baseline will display significantly higher
quit rates at the 5-year follow-up as compared to subjects who did not receive nicotine
patches at baseline.
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