Smoking Cessation With the Nicotine Patch: A Pilot Study of Patch Messaging

Quitlines have become central to state tobacco control efforts in the U.S. In addition to
offering telephone counseling, many quitlines have begun providing quitting aids (e.g.,
nicotine patch) to eligible smokers. The nicotine patch has been shown repeatedly to double
the rate of quitting success compared to a placebo control. Recently a number of studies have
examined the use of patches prior to quitting. A meta-analysis indicates that such
pre-cessation treatment with nicotine patches doubles the odds of quitting, compared to
starting patch treatment on the quit day, as is traditionally done.

The proposed study would look at both pre-cessation treatment with nicotine patches as well
as looking to see if sending clients nicotine patches is helpful in their quitting process.
The rationale for pre-cessation treatment with patches is that using patches in this manner
would make it easier to quit smoking because it may: reduce the reinforcing effects of
cigarette smoking, thus helping to overcome conditioned behavior; reduce the need for inhaled
nicotine as smokers naturally decrease their cigarette consumption to titrate the level of
nicotine in their system; and/or increase compliance with patch use in the quitting phase.

The rationale for sending nicotine patches is that when callers must go and get the patches
on their own it creates a barrier to their quitting so that sending nicotine patches directly
to a callers' home would make it easier for them to stay on task and quit. This pilot will
allow us to test the feasibility of sending pre-treatment nicotine patches and to examine the
effects associated with the pre-cessation treatment phase.

This pilot project has the following specific aims, to examine whether:

1. Subjects will use pre-cessation nicotine patches.

2. Subjects in the pre-cessation nicotine patches go on to get more nicotine patches.

3. Pre-cessation treatment with nicotine patches leads to a decrease in number of
cigarettes smoked per day.

4. Sending 2-weeks' worth of patches is helpful to the quitting process.

Results will add to the theoretical understanding of behavior change from which new,
effective interventions can spring.

Inclusion Criteria:

- >= 18 years old

- Daily smoker

- >=10 cigarettes per day

- Ready to quit within one month

- First time quitline caller

- Valid phone number

- Valid address (no P.O. boxes)

- California resident

- Agree to participate in study and evaluation

- English speaking

Exclusion Criteria:

- Uses other form of tobacco

- Plan to use quitting aids other than nicotine patch

- Has any of the following conditions:

- Severe allergy to adhesive tape

- Arrhythmia

- Angina

- Heart attack within last 6 months

- Stroke within last 6 months

- Uncontrolled high blood pressure

- Insulin-dependent diabetes

- Pregnancy