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Impact of messages recommending concomitant use of NRT and cigarettes

Impact of messages recommending concomitant use of NRT and cigarettes. Jean-François ETTER University of Geneva, Switzerland Jacques LE HOUEZEC Björn LANDFELDT Pharmacia AB, Helsingborg, Sweden. Background. NRT only for EX-smokers, in most countries

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Impact of messages recommending concomitant use of NRT and cigarettes

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  1. Impact of messages recommending concomitant use of NRT and cigarettes Jean-François ETTER University of Geneva, Switzerland Jacques LE HOUEZEC Björn LANDFELDTPharmacia AB, Helsingborg, Sweden

  2. Background • NRT only for EX-smokers, in most countries • Consumers are warned against concomitant use of NRT and cigarettes • BUT: some people cannot or don't want to quit • They may want to use both NRT and cigarettes • Smoking bans are more and more prevalent • Debate : smoking reduction an option ?

  3. Background • Concomitant use of NRT and cigarettes conveys no additional risk, compared to the risk of smoking, even in smokers with heart disease • Benowitz & Gourlay. J Am Coll Cardiol 1997 • Joseph et al. New Engl J Med 1996 • Mahmarian et al. J Am Coll Cardiol 1997 • Murray et al. Chest 1996 (Lung Health Study) • Working group... Arch Intern Med 1994

  4. Potential problem • Suspicion that encouraging concomitant use could be interpreted as an alternative to smoking cessation, with a negative impact on motivation to quit smoking

  5. Objective • To assess the impact on smokers' intention to quit of messages on concomitant use of NRT and cigarettes

  6. Methods • Randomized trial on the internet, June 2002 • E-mail to 9,074 smokers and ex-smokers • Randomly assigned to one of 4 groups • Each group received a different message • Answer = 1 click on 1 response option in e-mail • Then, window pops up with 29-item questionnaire

  7. Outcome • Perceived impact of the message on motivation to quit smoking (1 click in e-mail) • Perceived impact of the message on motivation to use NRT (in 29-item questionnaire)

  8. The messages • 1- "Control" message: "NRT attenuates withdrawal symptoms in smokers who want to quit smoking" • 2- "Temporary abstinence" message: Control + "Although total smoking cessation is preferable, NRT can also be used in situations where a smoker temporarily abstains from smoking (e.g. at work, on a plane, in a meeting)"

  9. The messages • 3- "Smoking reduction" message: Control + "Although total smoking cessation is preferable, this drug can be used by smokers who do not want to quit smoking, but wish to reduce their consumption of tobacco" • 4- "Side effects" message: Control + "It is essential to stop smoking from the start of the treatment. Otherwise you may experience adverse effects because of higher concentrations of nicotine in the blood than during usual smoking"

  10. Response options to e-mail Single answer, 1 click on appropriate link, directly in e-mail: This message... 1- ...definitely increases my motivation to quit 2- ...may increase my motivation to quit 3- ...has NO impact on my motivation to quit 4- ...may decrease my motivation to quit 5- ...definitely decreases my motivation to quit 6-... I don't know

  11. Participation • Answer to e-mail: n=2027 (25% of 8124 valid e-mail addresses) • Answer to 29-item questionnaire: n=1252 (62% of 2027, 15% of 8124) • E-mail: participation lower for the "Temporary abstinence" group than for other groups (- 4%, p<0.001 for all pairwise comparisons)

  12. Participants in 29-item survey

  13. Impact on motivation to quit smoking In current smokers only (e-mail)

  14. Impact on motivation tu use NRT In current smokers only (29-item survey)

  15. Conclusions • A message on NRT use for temporary abstinence had NO impact on motivation to quit smoking or to use NRT • A message encouraging concomitant use of NRT and cigarettes for smoking reduction may have POSITIVE impact on motivation to quit smoking and to use NRT • Concerns about negative impact are unjustified • Message on side effects = negative impact: drop it?

  16. Slides at: STOP-TABAC.CH

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