Nicotine replacement therapy in a group model HMO.

OBJECTIVE: To examine patient response to a smoking cessation program that combined a nicotine replacement system (patch) with telephone support. DESIGN: Randomized trial. SETTING: A large Midwestern HMO. PARTICIPANTS. Five hundred and nine smokers who attended orientation sessions where an overview of the study and the use of the nicotine patch was presented. INTERVENTION: All subjects received a prescription for a nicotine replacement patch (Prostep, Lederle Laboratories, Wayne, NJ). Participants were randomly assigned to one of three intervention groups. Group I participants (n = 166) received no additional support. Group II participants (n = 167) were registered with a 24-hour telephone hotline. Group III participants (n = 167) were registered with the 24-hour telephone hotline and received four follow-up telephone calls from health educators. OUTCOME MEASURE: The primary outcome measure was smoking cessation. Subject satisfaction with study components was also evaluated. RESULTS: Overall, there was no significant difference by group in smoking cessation rates: 20% of patients in all three groups were smoke-free after 12 months. Few patients (1%) used the telephone hotline. The telephone follow-up did not have an impact on cessation rates, and most patients (92%) reported that the orientation session was useful. CONCLUSIONS: The study experience has helped the HMO evaluate various study components and has had an impact on currently used telephone intervention strategies and educational materials.