Attitudes toward nicotine replacement therapy in smokers and ex-smokers in the general public

OBJECTIVE: Nicotine replacement therapy (NRT) doubles the chances that a smoker will quit smoking, but most smokers who attempt to quit do not use it at all or only use it inconsistently. We aimed to identify attitudes of smokers and ex-smokers toward NRT and to develop and assess the validity of a brief scale used to measure these attitudes. METHODS: We conducted a first mail survey of 256 smokers and ex-smokers to collect qualitative data and to develop survey items and a second mail survey of 494 smokers and ex-smokers to finalize the scale and assess its validity. The study was conducted in Geneva, Switzerland, in 1998 to 1999. RESULTS: The study resulted in a 2-dimensional, 12-item scale: the Attitudes Toward Nicotine Replacement Therapy scale (ANRT-12). The 2 subscales measure perception of the advantages of NRT (8 items) and the drawbacks of NRT (4 items). Internal consistency coefficients (alpha = 0.84 and 0.75, respectively) and test-retest correlations (0.79 for both scales) were high. The scales respected criteria of content and construct validity. Scores were associated with intention to use NRT, and among those who had ever used NRT, with the number of days of use. A disturbing result was that only 1 (16%) of 6 participants agreed that "NRT helps people quit smoking," and only 1 (24%) of 4 ex-smokers had ever used NRT. CONCLUSIONS: Many smokers and ex-smokers have inadequate knowledge of and negative attitudes toward NRT. ANRT-12 is a valid and reliable measure of these attitudes; it can be used by clinicians, researchers, and educators to improve use of and compliance with NRT.