Impact on quit attempts of mailed general practitioner 'brief advice' letters plus nicotine replacement therapy vouchers

Aim: To test whether a personalised letter from general practitioners advising their patients who are smokers to quit, together with an exchange card for one month of nicotine gum, prompts them to make quit attempts, is acceptable and feasible. Methods: Non-randomised before-after ecological study involving general practices in Auckland, New Zealand. Personalised letters with exchange cards for four weeks of nicotine gum were sent to 831 patients within a single Auckland health board area who were recorded as current smokers on their general practitioner's files. The comparison group was the population in another Auckland health board area. We measured calls to Quitline and vouchers redeemed at pharmacies from both areas before and after the intervention. Follow-up surveys of recipients and general practitioners assessed acceptability. Results: Quitline calls from baseline to the end of the intervention from the intervention district compared with a comparison district were not significantly higher (5%, 95% CI -2-12%, p=0.195), but nicotine replacement therapy (NRT) voucher redemptions were significantly higher (9%, 95% CI 3-16%, p=.005). Almost 9% of the exchange cards were redeemed for NRT. Despite initial difficulties in accurately identifying smokers from their records, responding GPs found the strategy very acceptable. Discussion: The strategy shows potential as a simple way to increase the number of smokers making supported quit attempts through primary care. In the light of the urgent need to increase cessation rates, a randomised trial of this promising approach is warranted.