The impact of a free nicotine patch starter kit on quit rates in a state quit line

All states offer telephone quit lines but they are under-used in part because of the costs associated with promotion. Offering nicotine replacement therapy (NRT) as well as behavioral counseling can increase treatment participation and abstinence rates, but is expensive. Offering less than a full NRT 8-week course can also generate calls to the quit line but less is known about its impact on program outcomes. In October 2004, Oregon-a state with over 3 million people, 500,000 smokers, and a state-funded quit line-introduced the Free Patch Initiative: a free 2-week introductory supply of NRT with phone counseling offered to all callers. We examined the impact of this intervention among insured callers. Most (97.2%) requested free patches, 86.2% used them, and 47.2% obtained additional patches on their own. Six-month outcome data were obtained from insured quit line participants before (n=268) and after (n=614) the Initiative launched. Compared with pre-initiative controls, Free Patch participants were more satisfied with the quit line (84.8%, vs. 89.8%; p=.04) and had higher 7-day quit rates using the assumption that eligible nonrespondents are smokers (9.3%, vs. 17.0%, OR=2.0; 95% CI 1.4-2.8) and using respondent only analysis (19%, vs. 33.6%, OR=2.15; 95% CI 1.52-3.04). Offering a free direct mail starter pack of NRT along with telephone counseling is an effective, cost-sharing method for promoting quit line use, enhancing participant satisfaction, and increasing the reach and effectiveness of quit lines among quit line callers with health insurance.