Delivery of a Nicotine Replacement Therapy Sample at Outdoor Smoking Hotspots for Promoting Quit Attempts: A Pilot Randomized Controlled Trial

INTRODUCTION: Outdoor smoking hotspots are convenient venues for promoting smoking cessation. This randomized controlled trial (RCT) aimed to obtain proof-of-concept evidence of the feasibility and preliminary effectiveness on quit attempts of delivering a 1-week free nicotine replacement therapy sample (NRTS) to smokers. METHODS: This pilot parallel, single-blinded, 2-group (1:1) RCT proactively recruited adult smokers in outdoor smoking hotspots in Hong Kong. Smokers consuming ≥10 cigarettes per day and fit for NRT use were individually randomized to receive either a 1-week NRT gum/patch and brief advice lasting 10 minutes (NRTS, n=50), or receive only brief advice (control, n=50). The primary outcomes were any self-reported quit attempts (stop smoking for at least 24 hours) at 1- and 3-month telephone follow-up. Risk ratios from log-binomial regression models were used to assess the associations. RESULTS: The NRTS increased quit attempts at 1-month (14% versus 10%; adjusted risk ratio (ARR) = 1.25, 95% CI 0.43-3.61) and 3-month follow-up (26% versus 12%; ARR = 2.17, 95% CI 0.89-5.27), but the differences were not significant. Trial participation rate was about 81.3%. Around 54% of the intervention group participants used the NRT sample by the first month. The NRT users reported generally positive feedback about the usefulness of NRT sample for smoking cessation. Major factors of not using NRT included bad gum taste and their perception that NRT was not useful. CONCLUSIONS: Delivering NRTS to smokers in outdoor smoking hotspots was feasible and efficacious in increasing NRT use. Additional post-recruitment support to sustain the use of NRT and cessation services is needed.