For example, one study showed that 8 weeks of nicotine patches yielded significantly higher 6-month abstinence rates than did 2 weeks of patches when both were offered to uninsured quitline callers selleck inhibitor (McAfee et al., 2008). However, a study of callers to the New York State Smokers�� Quit Line showed no significant differences in 7-month abstinence rates among those receiving either 2, 4, or 6 weeks of nicotine patches (Cummings et al., 2011). More recently, Ferguson et al. (2012) examined the effect of offering free NRT (vs. no NRT) with either standard or more intensive counseling in a 2 �� 2 factorial design that recruited 2,591 smokers via the English national quitline. Neither the free NRT nor the more intensive counseling improved cessation rates at 6 months postquit.

However, treatment assignment only modestly affected treatment exposure. Actual counseling utilization was similar in the two counseling groups; also, only about half the participants in the NRT group actually obtained the NRT and some participants not offered NRT obtained and used NRT on their own. Thus, the lack of significant effects may be due to functionally similar treatments as well as other methodological differences between studies (McAFee, Fellows, & Zbikowski, 2012). No studies have addressed the relative efficacy of single- agent NRT versus combination NRT among quitline callers. Longer duration NRT and combination NRT boost cessation outcomes in nonquitline studies (Fiore et al., 2008; Piper et al., 2009; Smith et al., 2009; Stead, Perera, Bullen, Mant, & Lancaster, 2008); however, differences between quitline and face-to-face intervention contexts (e.

g., differences in participants, intensity of counseling, and barriers to counseling and research participation) limit generalization of such findings. Moreover, recent data have cast doubt on the effectiveness of cessation pharmacotherapies in real-world use (e.g., Alpert, Connolly, & Biener, 2013; Ferguson et al., 2012), increasing the need to demonstrate effects in conditions that approach such use contexts. There is strong evidence that nonadherence to cessation medication is common among smokers, especially in real-world effectiveness studies (Ossip, Abrams, Mahoney, Sall, & Cummings, 2009; Schmitz, Sayre, Stotts, Rothfleisch, & Mooney, 2005; Wiggers et al., 2006) and is associated with reduced clinical success (Catz et al.

, 2011; Lam, Abdullah, Chan, & Hedley, 2005; Shiffman, Sweeney, Ferguson, Sembower, & Gitchell, 2008). Therefore, this research tested a medication adherence intervention that was designed to address problematic beliefs or knowledge about NRT that might adversely affect appropriate use of the pharmacotherapies. Dacomitinib Thus, the current study tested combination NRT (vs. nicotine patch only), longer duration of NRT (6 vs. 2 weeks), and the medication adherence intervention (vs.