Impact of messages on concomitant use of nicotine replacement therapy and cigarettes: a randomized trial on the Internet

AIMS: To assess the impact of messages recommending the concomitant use of nicotine replacement therapy (NRT) and cigarettes on smokers' intention to quit smoking. DESIGN: Randomized trial. SETTING: Internet. PARTICIPANTS: A total of 2027 people who answered an e-mail sent to 9074 current and former smokers recruited on a smoking cessation website. INTERVENTION: Participants were divided randomly into four groups, each of which received a unique message (in French) by e-mail. The 'control' message said that nicotine replacement therapy (NRT) attenuates withdrawal symptoms in smokers who want to quit. The 'temporary abstinence' message added that NRT can also be used by current smokers to manage smoke-free situations. The 'reduction' message indicated that NRT can be used by current smokers who do not want to quit but want to smoke fewer cigarettes. The 'side-effects' message discouraged concomitant use of NRT and cigarettes. MEASUREMENTS: Perceived impact of these messages on motivation to quit smoking. FINDINGS: The e-mail was answered by 2027 people (25% of 8124 valid addresses). Smokers who received the 'reduction' message were slightly more likely than controls to report that this message increased their motivation to quit (66% versus 60%, P = 0.02). In contrast, smokers who received the 'side-effects' message were less likely than controls to report that this message increased their motivation (45% versus 60%, P < 0.001). The 'temporary abstinence' message had no detectable impact on motivation to quit. CONCLUSIONS: Among smokers recruited via a smoking cessation website, messages encouraging concomitant use of NRT and cigarettes may have either no effect or a positive effect on motivation to quit smoking.