Uninsured smokers who used nicotine replacement therapy (NRT) patches in combination with NRT lozenges nearly doubled their quit rates when using the support of a quitline, according to a study published online ahead of print in the Journal of Smoking Cessation.

A team of scientists from Roswell Park Cancer Institute (RPCI), the Medical University of South Carolina, Yale University School of Medicine and the University at Buffalo (UB) evaluated the smoking quit rates of more than 3,000 daily tobacco users who contacted the New York State Smokers’ Quitline. One group of heavy smokers was given a free two-week supply of nicotine patches. A second group of heavy smokers was provided a free two-week supply of both nicotine patches and lozenges. Supportive counseling and follow-up calls were provided by trained Quitline specialists.

The results indicated that combination NRT was no more effective in a single-type therapy overall. However, subgroup analyses provided useful insights into reaching and assisting heavy and uninsured smokers. For example, the use of combination therapy can result in higher quit rates among groups reporting a lower socioeconomic status (SES) and lower nicotine dependence.

Findings of note:

  • Quit rates were higher for those given combination therapy compared to those given a single therapy, although they were not significantly different overall.
  • Specific subgroups, including uninsured smokers, using combination therapy compared with uninsured smokers using a single therapy had significantly higher quit rates.
  • The offer of a free supply of nicotine medication was rated as “very important” by smokers in both groups.
  • NRT usage was higher among those who received combination therapy compared to those who received a single type of therapy.
  • Reported relief from cravings was significantly greater among those who received the combination therapy.
  • The estimated cost of providing NRT was lower among the uninsured participants receiving combination therapy versus those receiving a single therapy, due to the difference in the quit rates.