BACKGROUND: Nicotine replacement therapy (NRT) sampling by layperson may be a scalable approach to increasing access to and uptake of smoking cessation treatment. This trial evaluated the effectiveness of 1-week NRT sampling delivered by laypersons in increasing tobacco abstinence among smokers in the community.
METHODS: This was a territory-wide, 2-arm pragmatic cluster-randomised controlled trial nested within a “Quit to Win” contest in Hong Kong. Trained laypersons proactively recruited adults aged 18 years or older who consumed cigarettes, electronic cigarettes or heated tobacco products daily from 88 community sites. All participants received brief cessation advice at baseline and were offered referrals to a smoking cessation service of their choice at 1-, 2-, and 3-month follow-ups. Participants in the intervention group additionally received a 1-week sample of NRT patches or gum at baseline. The primary outcome was biochemically validated tobacco abstinence at 6-month follow-up. Secondary outcomes included self-reported 7-day point-prevalent abstinence, 24-hour quit attempt, NRT use and smoking cessation service use at 3 and 6 months. Analyses were by intention-to-treat. The trial was registered with ClinicalTrials.gov (NCT05881083).
RESULTS: From June 17 to October 31, 2023, 1017 participants (79.6% male, mean [SD] age=44.9 [15.0] years, 95.8% cigarette smokers) were cluster-randomised to the intervention (N=559) or control (N=458) groups. At 3-month follow-up (retention rate 70.3%), biochemically validated tobacco abstinence was similar between the intervention and control groups (18.3% vs 16.4%; p=0.43). For self-reported outcomes, any NRT use was significantly higher in the intervention than control group (50.6% vs 20.3%, p<0.001), but there was no significant difference in smoking cessation service use (19.0% vs 20.1%; p=0.65), quit attempt (66.7% vs 70.5%, p=0.20), and 7-day point-prevalent abstinence (25.6% vs 25.1%; p=0.86).
CONCLUSIONS: The trial showed that 1-week NRT sampling increased NRT use but not tobacco abstinence or cessation service use at 3 months among smokers proactively recruited from the community.