Adverse effects with use of nicotine replacement therapy among quitline clients.

INTRODUCTION: Nicotine replacement therapy (NRT) increases quit rates and is increasingly distributed through quitlines, but no systematic data are available on adverse effects and safety among quitline NRT users. METHODS: Smokers who contacted the New York State Smokers' Quitline and were sent free NRT were followed by phone at 2 weeks (n = 33,690), and a randomly selected subsample was followed at 3 months (n = 1,187). All were asked about their use of NRT and adverse effects. Prevalence and perceived severity (rated mild, moderate, or severe) of selected adverse side effects were assessed. Subjects also were asked about their smoking behavior while using NRT and reasons for discontinuation of NRT. RESULTS: Among those who reported having used NRT at the 2-week contact, about one in four reported an adverse effect. This rate increased to about 42% among those surveyed at 3 months. The prevalence and specific types of adverse effects reported were consistent with findings from clinical trials of NRT and varied in relationship to the type of NRT used (patch, gum, lozenge). The majority of adverse effects reported were rated as mild, and only 4.4%-5.4% of subjects (across the 2-week and 3-month follow-ups) reported discontinuation of NRT as a result of adverse effects. DISCUSSION: The prevalence and types of adverse effects observed among smokers receiving NRT were as expected with product labeling and support the conclusion that the distribution of over-the-counter NRT through quitlines is safe as long as clients are screened adequately per the labeling instructions.

Smokers' acceptance of "cold calls" offering quitline services.

OBJECTIVE: A random sample of smokers was offered a transfer to the New York State Smokers' Quitline in order to assess smokers' acceptance of "cold calls" offering quitline services. METHOD: A 30-minute survey to assess adult tobacco use was administered to 121 western New York smokers who were originally sampled for a random digit dialled survey in 2005, and then re-interviewed one year later, between April and July 2006. Smokers' interest in receiving immediate quitline assistance was assessed at the end of the survey, when the smokers could choose to be transferred to the New York State Smokers' Quitline in order to receive the quitline's cessation services. RESULTS: 41% of smokers accepted the offer for, and subsequently received, New York State Smokers' Quitline services. After controlling for factors related to cessation, women were more likely to respond to the offer. CONCLUSIONS: Although telephone quitline utilisation is low, these data suggest that the demand is high and "cold calls" may be a strategy to extend the use of quitline cessation services.

Hair dye use, meat intake, and tobacco exposure and presence of carcinogen-DNA adducts in exfoliated breast ductal epithelial cells.

Diet and environmental exposures to aromatic and heterocyclic amines, and polycyclic aromatic hydrocarbons, are thought to be etiologic factors for breast cancer risk. In this study, we chose to quantify the major DNA adduct derived from one member of each of these classes of carcinogens in epithelial cell DNA isolated from human breast milk. Appreciable adducts were detected for each class, namely 2-amino-6-phenylimidazo[4,5-b]pyridine (PhIP), 4-aminobiphenyl (ABP) and benzo[a]pyrene. The effect of several metabolic genotypes on adduct levels were also investigated and higher PhIP and ABP adducts were associated with the rapid NAT2 and/or rapid NAT1 genotypes. The presence of ABP adducts was also significantly associated with the use of hair coloring products (OR=11.2, 95% CI=1.1-109.2) but not tobacco usage. These data indicate that women are exposed to several classes of dietary and environmental carcinogens and that metabolic genotype can be a susceptibility factor.

Early evidence on the effectiveness of clean indoor air legislation in New York State.

In July 2003, New York State implemented the Clean Indoor Air Act (CIAA) to reduce exposure to environmental tobacco smoke (ETS). In this cross-sectional study, workers (n=168) completed an interview assessing ETS exposure and provided urine for cotinine analysis. Hospitality workers recruited after implementation of the CIAA had significant reductions in ETS exposure and urine cotinine, compared with those recruited before implementation. The New York State CIAA yielded measurable reductions in ETS exposure for hospitality workers.