Researchers say that communities can effectively cut smoking rates by increasing access to Quitline-type smoking-cessation services and offering free nicotine patches to smokers.

Scientists at Kaiser Permanente's Center for Health Research in Portland, the Oregon Health Department, and the Free & Clear phone-based treatment program in Seattle found that the number of callers to the Oregon Tobacco Quitline more than doubled -- and quit rates nearly doubled -- when the state began promoting the service by offering a two-week supply of nicotine patches along with a 30-minute telephone counseling session.

The study found that the "cost per quit" to the state fell from $3,778 to $1,050 even though spending on the program increased, according to Kaiser Permanente researcher Jeffrey Fellows, Ph.D., and colleagues.

In a second study, researchers examined six different levels of Quitline-based services and found that 21 percent of smokers who received intensive counseling plus nicotine-replacement therapy quit smoking, compared to 11.7 percent who received brief counseling and no nicotine-replacement therapy.

The former regime cost $268 per person, compared to $67 per person for the latter. "Policymakers for state Quitlines might choose to offer only brief counseling with no NRT because the cost per caller is lower," said Kaiser Permanente's Jack Hollis, Ph.D.bj, lead author of the study. "However, our results suggest that higher quit rates, greater client satisfaction, and the potential to attract more smokers to Quitlines more than offset the modest additional costs. Heavily addicted smokers, who have the highest health care costs over time, may benefit even more from intensive counseling and medication."

The research appears in the December 2007 issue of the journal Tobacco Control.