Real-World Effectiveness of Nicotine Replacement Therapy Sampling in Chinese Women of a Sex-Specific Smoking Cessation Program in Hong Kong, China.

Introduction: Nicotine replacement therapy (NRT) sampling has been shown effective in increasing smoking abstinence by trials, but the real-world effectiveness in women is unknown. We examined the effectiveness of 1-week NRT sampling combined with counseling on smoking abstinence in Chinese women.

Aims and methods: A prospective study was conducted on 545 Chinese women (mean age: 37.7 years) receiving nurse-delivered smoking cessation counseling from the Women Quit program in Hong Kong from 2006 to 2023. 1-week free NRT sampling was offered to all participants. Participants were categorized based on NRT usage at 1 month: non-users (n = 255), users of < 1 week (n = 112), and 1-week users (n = 178). The primary outcome was self-reported 7-day point prevalence of abstinence (PPA) at 6 months.

Results: Compared with non-users receiving counseling alone, 1-week users had higher 7-day PPA at 3- (aRR 1.66, 95% CI: 1.24 to 2.20) and 6-month (aRR 1.71, 95% CI: 1.29 to 2.25), higher 60-day (aRR 1.55, 95% CI: 1.03 to 2.33) and 150-day continuous abstinence (aRR 2.06, 95% CI: 1.33 to 3.20), and higher smoking reduction rates at 3- (aRR 1.66, 95% CI: 1.27 to 2.17) and 6-month (aRR 1.47, 95% CI: 1.07 to 2.02) follow-ups. Users of < 1 week had similar smoking abstinence and reduction rates compared with non-users (all p > .05). Higher 7-day PPA at 6 months of 1-week users was observed in lower versus higher education and income (both p for interaction < 0.05).

Conclusions: The evidence presented suggests the real-world effectiveness of 1-week NRT sampling combined with counseling for increasing smoking abstinence and reduction rates in women. This implies that encouraging sampling of NRT will improve smoking cessation outcomes, particularly for women of low socioeconomic status.

Implications: We found that using 1-week NRT sampling combined with counseling was associated with higher smoking abstinence and reduction rates compared with counseling alone in women receiving a quitline service. We also found that women with socioeconomic disadvantages and older age benefited more from the use of 1-week NRT sampling. These findings highlight the importance of offering and promoting the use of 1-week NRT sampling as part of smoking cessation programs for women, particularly those with lower socioeconomic status, potentially to narrow cessation disparities.