Grant: Project Grant

Quitting smoking is the most effective way of reducing the risk of cancer. One way of helping people stop smoking is to provide them with free Nicotine Replacement Therapy (NRT; e.g., nicotine patch), such as when NRT is sent to people by postal mail as part of a mass distribution initiative. Our previous research indicated that the impact of the mailed NRT intervention on increasing quit rates in rural areas may be substantial. The current research project seeks to confirm this finding and to understand the social determinants of health driving these anticipated large effects. This information is essential in order to target limited health resources to regions that are most in need, and who are likely to experience the greatest benefit. Telephone numbers will be randomly selected from across rural regions of Canada in order to recruit adult smokers interested in completing a smoking survey and willing to be interviewed again in 6 months. The survey will ask participants about their smoking history, demographic characteristics, and a hypothetical question: would they be interested in receiving the nicotine patch if this were provided to them free of charge? Half of the smokers interested in receiving nicotine patches will be selected by chance and offered the NRT package. The other half of smokers will not be offered the nicotine patches until after the 6-month follow-up interview. In addition, the municipality where each participant lives will be identified and participant data will be linked to relevant municipal characteristics (e.g., smoking rates, availability of health services). Characteristics of the participants and the municipalities in which they live will be used to explain why the nicotine patch intervention has a larger impact in some rural regions compared to others. Finally, comparisons will be made with our existing urban study sample in order to shed further light on why the impact of the NRT intervention may be so large in rural settings.