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Feasibility of Delivering Varenicline Through a Telephone Quitline to Promote Smoking Cessation

Published online by Cambridge University Press:  19 February 2018

Alana M. Rojewski ,
Andrew Hyland ,
Martin C. Mahoney ,
Louise M. Cooper ,
Kelly L. Zuromski ,
Paula Celestino ,
James Koutsky  and
Benjamin A. Toll
Alana M. Rojewski
Affiliation:
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
Andrew Hyland
Affiliation:
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
Martin C. Mahoney
Affiliation:
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
Louise M. Cooper
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY
Kelly L. Zuromski
Affiliation:
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
Paula Celestino
Affiliation:
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
James Koutsky
Affiliation:
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
Benjamin A. Toll*
Affiliation:
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC Hollings Cancer Center, Medical University of South Carolina, Charleston, SC Department of Psychiatry, Yale School of Medicine, New Haven, CT
*
Address for correspondence: Benjamin A. Toll, PhD, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, MSC 835, Charleston, SC, 29425-8350. Email: toll@musc.edu
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Abstract

Introduction: Telephone quitlines are an easily accessible and effective means for delivering cessation services including nicotine replacement therapy (NRT). Varenicline (VAR) may show superior quit rates to NRT, but has not been routinely evaluated in the context of quitlines.

Aims: To assess the feasibility of distributing VAR through a quitline, and preliminarily compare cessation rates between participants receiving VAR and NRT.

Methods: Participants were recruited through the New York State Smokers’ Quitline. Those randomised to VAR (n = 200) were instructed to obtain a prescription from their primary care physician (PCP) to be filled by mail through the research pharmacy. Those randomised to NRT (n = 100) were mailed NRT using an existing protocol. Outcome measures were number of submitted prescriptions and dispensed medication kits, and self-reported 7-day point prevalence abstinence at follow-up.

Results: The research pharmacy filled 100% of prescriptions through the quitline. However, only 27% of the VAR Arm submitted a prescription. An intent-to-treat analysis revealed that those receiving NRT were more likely to be abstinent at follow-up than the VAR Arm (OR, 2.42; 95% CI, 1.27–4.60; p < 0.01). The per-protocol analysis, which only included those in the VAR Arm who submitted a prescription, showed no difference in quit rates.

Conclusions: The present protocol resulted in successful delivery of VAR through the quitline, but a sizable proportion of the VAR Arm did not submit a prescription. Self-reported barriers included being unable to obtain a prescription from a PCP. Future studies should explore alternative methods for delivering VAR through quitlines.

Type
Original Articles
Information
Journal of Smoking Cessation , Volume 13 , Issue 4 , December 2018 , pp. 201 - 206
Copyright
Copyright © The Author(s) 2018 

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