FreSH (Free Samples for Health)

Effectiveness of Nicotine Replacement Therapy Sampling in Dental Practices

Most oral health professionals advise their smoking patients to quit, but often fail to connect them with smoking cessation medications, which are crucial for effective treatment. This cluster-randomized implementation-effectiveness trial will assess whether combining brief advice with nicotine replacement therapy (NRT) sampling during routine dental visits increases quit attempts and abstinence rates. NRT sampling involves providing patients with free samples of nicotine patches and lozenges.

Smoking adversely impacts oral health, and cessation can reduce related issues. Most smokers try to quit without medication, which can lead to relapse. The American Dental Hygienists Association recommends the Ask-Advise-Refer (AAR) strategy to encourage smoking cessation, but does not refer patients to cessation medications, which could significantly enhance success rates.

NRT sampling is considered a viable option in dental settings owing to routine product distribution. This 5-year study will evaluate the effectiveness of NRT sampling in dental practices, beginning with a 2-year planning phase to assess feasibility and acceptability, followed by a 3-year implementation phase that includes stakeholder interviews and pilot testing.

We will compare AAR + NRTS to enhanced usual care (AAR + electric toothbrush) with 50 practitioners and 1,200 patients from the Northeast and Midwest. Our primary outcome will be 7-day verified abstinence at 6 months post-intervention. We anticipate that NRTS will lead to higher abstinence rates, enhance quit attempts, reduce smoking heaviness, and increase NRT use. Additionally, we will conduct a process evaluation and a cost-effectiveness analysis to inform future implementation and to establish NRTS's feasibility and effectiveness in clinical practice.

Project Details

  • Dates: October 2022 – July 2025
  • Funding Source: National Institute of Dental & Craniofacial Research
  • Grant Number: UH3DE029973

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