Background:
Tobacco use disparities exist despite the widespread dissemination of evidence-based tobacco cessation interventions. Pharmacists are under-utilized community resources to address tobacco control, given their centralized placement in the community, clinical expertise and frequent patient interactions; however, pharmacists rarely provide tobacco cessation services to their customers due to a lack of standardized, reimbursable programs.

Objective:
The goal of this study was to determine the feasibility of delivering a smoking cessation intervention through independent pharmacies in rural communities that uses a standard documentation and billing system for pharmacy reimbursement of services.

Methods:
Twenty-four rural smokers were randomized in a fully crossed factorial design to: 1) QuitAid, a pharmacist delivered novel 5 session intervention (Yes vs No); 2) Combination nicotine replacement therapy (NRT) Gum + NRT Patch (vs NRT patch alone); and/or 3) 8 weeks of NRT (vs standard 4 weeks). The primary outcomes were the feasibility of the approach, as measured by feasibility of recruitment, randomization, and retention.

Results:
Participants were recruited within 7 weeks using an ask-adviseconnect method (66%) at a local independent pharmacy, while the rest were self-referred from store signage (16%), prescription bag advertisements (4%) and word of mouth (16%). Over 82% of the QuitAid sessions were completed, and 83% of participants were retained at the follow-up at 3 months. Overall, participants felt that the program was a good fit (Means: 3.69–4.62) and NRT was useful (Means: 4.38–4.46) on 5-point Likert scales. The community pharmacists reported that the QuitAid intervention was straightforward and well received by participants.

Conclusions:
A smoking cessation intervention that utilizes a standard documentation and billing platform could provide a highly disseminable avenue for pharmacist-delivered smoking cessation for hard-to-reach smokers. Because smoking cessation medications are primarily available through pharmacies, a unique opportunity exists for pharmacists to become the recognized community resource for providing smoking cessation medication support.