Effectiveness of Nicotine Replacement Therapy Sampling in Dental Practices

The FreSH study is a stage 3, cluster randomized, effectiveness trial. Ask Advise Refer (AAR) + Nicotine Replacement Therapy Sampling (NRTS) will be compared to enhanced usual care (AAR + electric toothbrush; ET) in approximately 1200 patients who smoke combustible cigarettes recruited from approximately 50 practices in the Northeast and Midwest regional nodes of the National Dental Practice-Based Research Network. Study interventions will be delivered within the practices by trained practitioners. Our central hypothesis is that NRTS will produce greater abstinence than ET. Our primary outcome will be carbon monoxide (CO) verified, 7-day point prevalence abstinence at 6-months post-intervention. We also predict that compared to ET, NRTS will increase quit attempts, reduce smoking heaviness, and increase NRT utilization. After the intervention is complete, we will conduct a multi-stakeholder process evaluation of the feasibility and acceptability of the NRTS intervention and a cost-effectiveness analysis to aid future implementation efforts.