COMMUNITY PATTERNS OF TRANSDERMAL NICOTINE USE AND PROVIDER COUNSELING

OBJECTIVES: To examine how transdermal nicotine is prescribed and used in the general population, and to identify variables associated with successful smoking cessation in patch users. DESIGN: Retrospective coh ort survey, SETTING: A random sample of 70 pharmacies In Ring County, Washington, were asked to participate. Of those, 33 pharmacies ran com puter searches of prescriptions for any nicotine patch dispensed betwe en July 1 and December 31, 1992. A total of 1,087 Individuals receivin g patches were identified, PATIENTS: At least eight months after the n icotine patches were purchased, 972 subjects received questionnaires b y mail from the participating pharmacies, The survey was completed by 433 (45.2%) subjects, MAIN RESULTS: Eighty percent of the respondents requested patches from a provider, 81% of whom were primary care physi cians. Ninety-six percent used the patch, 45% smoked while using the p atch, and 37% reported having quit smoking, Smoking cessation was asso ciated with daily patch application (odds ratio [OR] 1.6, 95% confiden ce interval [CI] 1.2-2.2), abstinence during patch use (OR 7.7, 95% CI 4.8-12.5), and a longer duration of patch use (p = 0.001). A score re flecting counseling intensity by the provider was associated with abst inence white using patches and smoking cessation (chi(2) for trend = 0 .01 and 0.04, respectively), CONCLUSIONS: Most nicotine patch users re quest treatment from a primary care physician, suggesting motivation t o quit. Almost half continue to smoke while using the patch, a behavio r that appears related to a lower level of counseling and an inability to quit. Increasing counseling may positively impact nicotine-patch-a ssisted smoking cessation in the general population.