Community patterns of transdermal nicotine use and provider counseling

J Gen Intern Med. 1995 Dec;10(12):656-62. doi: 10.1007/BF02602757.


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 cohort survey.

Setting: A random sample of 70 pharmacies in King County, Washington, were asked to participate. Of those, 33 pharmacies ran computer searches of prescriptions for any nicotine patch dispensed between July 1 and December 31, 1992. A total of 1,087 individuals receiving patches were identified.

Patients: At least eight months after the nicotine patches were purchased, 972 subjects received questionnaires by 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 physicians. Ninety-six percent used the patch, 45% smoked while using the patch, and 37% reported having quit smoking. Smoking cessation was associated with daily patch application (odds ratio [OR] 1.6, 95% confidence 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 reflecting counseling intensity by the provider was associated with abstinence while using patches and smoking cessation (chi 2 for tread = 0.01 and 0.04, respectively).

Conclusions: Most nicotine patch users request treatment from a primary care physician, suggesting motivation to quit. Almost half continue to smoke while using the patch, a behavior that appears related to a lower level of counseling and an inability to quit. Increasing counseling may positively impact nicotine-patch-assisted smoking cessation in the general population.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Cutaneous
  • Cohort Studies
  • Counseling / methods*
  • Drug Prescriptions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotine / administration & dosage*
  • Pharmacies
  • Practice Patterns, Physicians'*
  • Random Allocation
  • Retrospective Studies
  • Smoking Cessation*
  • Surveys and Questionnaires


  • Nicotine