A simple way to help people quit smoking, and a simple way to prevent young women from getting melanoma. This is Healthcare Triage News.

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First up, from JAMA Internal Medicine: Effect of Mailing Nicotine Patches on Tobacco Cessation Among Adult Smokers, a Randomized Clinical Trial. We know that nicotine patches work to help people quit smoking. That doesn't mean everyone uses them though. This trial was an attempt to make things easier for smokers to see if that would help them quit.

Adult smokers in Canada were recruited by random digit dialing over two years. The researchers managed to enrol 1000 people who smoke more than 10 cigarettes a day. They were interviewed and randomised to one of two groups. The first was mailed a five week supply of nicotine patches, the other was not. That's the study. No doctor's visits, no behavioral counselling, nothing else. They were called eight weeks later and six months later. The outcome of interest was whether people had been smoke-free for at least 30 days at six months. The quit rate among those who did not receive the nicotine patches was 3%. The quit rate among those who did receive the patches was 7.6%. Of course, that's what people said; it's possible they weren't telling the truth.

The researchers tried to get them to send in saliva samples, but only about half of the people did. Of those who did, the verified quit rate in the control group was 1%, versus 2.8% in the intervention group. The magnitude of the effect differs whether you rely on self-reported quitting, or saliva tests. But it's clear that simply mailing people nicotine patches at least doubled the quit rate of people quitting smoking. Compared to the effort and cost of behavioral interventions, this is a reasonably cost-effective intervention.

Next up, from JAMA Dermatology: Association Between Indoor Tanning and Melanoma in Younger Men and Women. Melanoma's on the rise! Researchers wanted to see if there's an association between indoor tanning in people younger than 50 years of age. They conducted a case-control study of women and men in Minnesota. They included 681 patients between the ages of 25 to 49 years who were diagnosed with melanoma between 2004 and 2007. They matched them to 654 controls. The exposure of interest was indoor tanning, including any use, the age of first use, and total number of sessions.

First off, women who were younger than 40 were more likely to have started tanning at a younger age. That means that tanning's picking up steam now. Those over 40 started tanning at 25, those younger than 40 started at 16. Those under 40 tan more too; a median of 100 sessions versus 40 for the older women. Younger women who tan were six times more likely to have melanoma than those who did not, and those tan more were more likely to have melanoma.

Yes, this is a case-control study, and yes those are relative risks. But consider this: pretty much all the women in the study; 96.8%, who develop melanoma before 30 years of age had engaged in indoor tanning. All of them had started indoor tanning before they were 25, and almost all of them tanned more than 10 times a year. Don't do it! Just don't.

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