Targeting Mailed Nicotine Patch Distribution Interventions to Rural Regions of Canada

Quitting smoking is the most effective way of reducing the risk of cancer. One way of helping people stop smoking is to provide them with free Nicotine Replacement Therapy (NRT; e.g., nicotine patch), such as when NRT is sent to people by postal mail as part of a mass distribution initiative. Our previous research indicated that the impact of the mailed NRT intervention on increasing quit rates in rural areas may be substantial. The current research project seeks to confirm this finding and to understand the social determinants of health driving these anticipated large effects. This information is essential in order to target limited health resources to regions that are most in need, and who are likely to experience the greatest benefit.

A two-stage recruitment process will be employed, in the context of a general population survey with a 6-month follow-up. Random digit dialling of telephone numbers from rural regions of Canada will identify households with adult (age 18 or over) smokers who smoke 10 or more cigarettes a day and who are willing to take part in a smoking study that involves two interviews. Residence of participants in rural regions will be confirmed by postal code matching. As part of the baseline survey, eligible subjects will be identified for the second recruitment - randomization of smokers into experimental and control conditions to be offered versus not offered Nicotine Patches. A randomized half of the eligible participants will be assigned to the experimental condition and asked for their permission to have Nicotine Patches sent to their home. The 6-month follow-up survey will be conducted 6-months after the baseline survey.

The primary hypothesis is that participants receiving the NRT package will display significantly greater quit rates (30 day abstinence) at 6-month follow-up as compared to those not offered the NRT package.

Inclusion criteria

• Smoke 10 or more cigarettes per day
• Willing to be interviewed at baseline and 6 months
• Interest in using nicotine patch to quit smoking
• Intent to use nicotine patch within 1 week of receipt
• Willing to have nicotine patches sent to their home

Exclusion criteria

• Contraindication to NRT patch use (e.g. pregnant, intending on becoming pregnant, allergic to tape, serious heart circulation problem, not including high blood pressure)