Trial Outcomes & Findings for Free Samples for Health (NCT NCT05627596)

Last Updated: 2026-07-24

Results Overview

Percentage reporting no smoking in the 7 days prior to the 6-month follow-up timepoint and having an exhaled carbon monoxide value of less than 6 parts per million

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

1239 participants

Primary outcome timeframe

6 months post baseline

Results posted on

2026-07-24

Participant Flow

Unit of analysis: Dental Practices

Participant milestones

Participant milestones
Measure	Electric Toothbrush Patients Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Overall Study STARTED	710 29	529 30
Overall Study Eligible for CO test	123 29	72 30
Overall Study CO results returned	82 29	53 30
Overall Study Patient participants	710 29	486 30
Overall Study Practitioner participants	0 0	43 30
Overall Study COMPLETED	526 29	353 30
Overall Study NOT COMPLETED	184 0	176 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.

Baseline characteristics by cohort

PRIMARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

Percentage reporting no smoking in the 7 days prior to the 6-month follow-up timepoint and having an exhaled carbon monoxide value of less than 6 parts per million

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
7-day Biochemically Confirmed Point Prevalence Abstinence	57 Participants Interval 0.65 to 2.09	41 Participants Interval 0.65 to 2.09

SECONDARY outcome

Timeframe: 1 month post baseline

Population: This outcome only applies to patient participants

Proportion reporting no smoking in the 7 days prior to the 1-month follow-up

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
7-day Self-reported Point Prevalence Abstinence	64 Participants Interval 1.03 to 2.88	62 Participants Interval 1.03 to 2.88

SECONDARY outcome

Timeframe: 3 months post baseline

Population: This outcome only applies to patient participants.

Proportion reporting no smoking in the 7 days prior to the 3-month follow-up

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
7-day Self-reported Point Prevalence Abstinence	106 Participants	66 Participants

SECONDARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

proportion reporting a quit attempt of 24 hours or longer in duration over the course of the study

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
24-hour Intentional Quit Attempts	346 Participants	284 Participants

SECONDARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

Change in cigarettes smoked per day from baseline to the 6 month follow-up

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Smoking Heaviness	-3.42 cigarettes per day Standard Deviation 4.76	-5.12 cigarettes per day Standard Deviation 7.21

SECONDARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

Proportion reporting using nicotine patch or nicotine lozenge in the 6 months following baseline

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Nicotine Replacement Therapy Utilization	90 Participants Interval 5.29 to 10.31	243 Participants Interval 5.29 to 10.31

SECONDARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

Single item measure of perceived nicotine replacement therapy safety, "Nicotine replacement therapy products (also known as NRT) include the nicotine patch, gum, lozenge, nasal spray, and inhaler. On a scale of 1 to 5, where 1 is not at all and 5 is very, how concerned are you about the safety of NRT products?" For this outcome, we report the change from baseline to the 6 month follow-up.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Perceived Nicotine Replacement Therapy Safety	-0.70 units on a scale Standard Deviation 1.65	-0.23 units on a scale Standard Deviation 1.70

SECONDARY outcome

Timeframe: 6 months post baseline

Population: This outcome only applies to patient participants.

Single item measure of perceived nicotine replacement therapy efficacy, "On a scale of 1 to 5, where 1 is not at all, and 5 is very much, how much do you think NRT products improve a smoker's chance of quitting successfully?" For this outcome, we report the change from baseline to the 6 month follow-up.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Perceived Nicotine Replacement Therapy Efficacy	-0.28 units on a scale Standard Deviation 1.41	-0.04 units on a scale Standard Deviation 1.42

OTHER_PRE_SPECIFIED outcome

Timeframe: From initiation of site enrollment to meeting target recruitment goal or study/site termination (an average of 1 year following site enrollment)

Population: This outcome only applies to practitioner participants.

Rating on a scale of 1 (completely disagree) to 5 (completely agree) on level of agreement with statements regarding the readiness for implementing organizational change (in this case, nicotine replacement therapy sampling). Scores range from 12-60 with higher scores indicating greater readiness for change.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=31 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Organizational Readiness for Change	50.58 units on a scale Standard Deviation 11.29	—

OTHER_PRE_SPECIFIED outcome

Timeframe: From initiation of site enrollment to meeting target recruitment goal or study/site termination (an average of 1 year following site enrollment)

Population: This outcome only applies to practitioner participants.

Rating on a scale of 1 (completely disagree) to 5 (completely agree) on level of agreement with statements regarding the acceptability of the intervention of the study (Nicotine replacement therapy sampling). Range is 1-5 with higher scores indicating greater acceptability.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=31 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Acceptability of Intervention Measure	4.46 units on a scale Standard Deviation 0.63	—

OTHER_PRE_SPECIFIED outcome

Timeframe: From initiation of site enrollment to meeting target recruitment goal or study/site termination (an average of 1 year following site enrollment)

Population: This outcome only applies to practitioner participants.

Rating on a scale of 1 (completely disagree) to 5 (completely agree) on level of agreement with statements regarding the intervention appropriateness of the study. cores range from 1-5 with 5 indicating greater appropriateness of nicotine replacement therapy sampling.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=31 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Intervention Appropriateness Measure	4.46 units on a scale Standard Deviation 0.69	—

OTHER_PRE_SPECIFIED outcome

Timeframe: From initiation of site enrollment to meeting target recruitment goal or study/site termination, an average of 1 year following recruitment

Population: This outcome only applies to practitioner participants.

Rating on a scale of 1 (completely disagree) to 5 (completely agree) on level of agreement with statements regarding the feasibility of the intervention of the study. Scores range from 1-5 with higher scores indicating greater feasibility.

Outcome measures

Outcome measures
Measure	Electric Toothbrush Patients n=31 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Feasibility of Intervention Measure	4.32 units on a scale Standard Deviation 0.81	—

Adverse Events

Electric Toothbrush Patients

Serious events: 0 serious events

Other events: 543 other events

Deaths: 0 deaths

Nicotine Replacement Therapy Patients

Serious events: 0 serious events

Other events: 339 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Additional Information

Sandra J. Japuntich/Principal Investigator

University of Minnesota

Phone: 612-873-6856

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place

Measure	Electric Toothbrush n=710 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy n=529 Participants Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges. Participants in this arm include patients assigned to the Nicotine Replacement Therapy intervention and practitioners delivering the Nicotine Replacement Therapy Intervention.	Total n=1239 Participants Total of all reporting groups
Age, Continuous Patients	47.34 years STANDARD_DEVIATION 13.83 • n=710 Participants • The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.	47.46 years STANDARD_DEVIATION 13.08 • n=486 Participants • The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.	47.39 years STANDARD_DEVIATION 13.53 • n=1196 Participants • The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.
Age, Continuous practitioners	—	43.4 years STANDARD_DEVIATION 12.4 • n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.	43.4 years STANDARD_DEVIATION 12.4 • n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey plus practitioners in the Nicotine Replacement therapy group. Information for practitioners was drawn from administrative data.
Sex/Gender, Customized Female patients	415 Participants n=710 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	291 Participants n=486 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	706 Participants n=1196 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.
Sex/Gender, Customized Male patients	291 Participants n=710 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	195 Participants n=486 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	486 Participants n=1196 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.
Sex/Gender, Customized missing/other patients	4 Participants n=710 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	0 Participants n=486 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	4 Participants n=1196 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.
Sex/Gender, Customized Male practitioners	0 Participants Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	17 Participants n=43 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	17 Participants n=43 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.
Sex/Gender, Customized Female practitioners	0 Participants Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	26 Participants n=43 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.	26 Participants n=43 Participants • Participants were divided into two groups, patients, and providers. Frequency of gender categories was calculated separately for patients and providers.
Ethnicity (NIH/OMB) patients · Hispanic or Latino	61 Participants n=710 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	28 Participants n=486 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	89 Participants n=1196 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Ethnicity (NIH/OMB) patients · Not Hispanic or Latino	638 Participants n=710 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	452 Participants n=486 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	1090 Participants n=1196 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Ethnicity (NIH/OMB) patients · Unknown or Not Reported	11 Participants n=710 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	6 Participants n=486 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	17 Participants n=1196 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Ethnicity (NIH/OMB) Practitioners · Hispanic or Latino	0 Participants The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	1 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	1 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Ethnicity (NIH/OMB) Practitioners · Not Hispanic or Latino	0 Participants The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	42 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	42 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Ethnicity (NIH/OMB) Practitioners · Unknown or Not Reported	0 Participants The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	0 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.	0 Participants n=43 Participants • The participants analyzed include all patient participants who completed the baseline survey and all practitioners in the nicotine replacement therapy sampling group. Practitioner data was drawn from administrative data.
Region of Enrollment United States	710 Participants n=710 Participants • The top table indicates patients, the bottom row indicates practitioners.	529 Participants n=529 Participants • The top table indicates patients, the bottom row indicates practitioners.	1239 Participants n=1239 Participants • The top table indicates patients, the bottom row indicates practitioners.
Baseline survey completion Patients	710 Participants n=710 Participants • The participants analyzed include all participants who completed the baseline survey.	486 Participants n=486 Participants • The participants analyzed include all participants who completed the baseline survey.	1196 Participants n=1196 Participants • The participants analyzed include all participants who completed the baseline survey.
Baseline survey completion practitioners	0 Participants The participants analyzed include all participants who completed the baseline survey.	36 Participants n=43 Participants • The participants analyzed include all participants who completed the baseline survey.	36 Participants n=43 Participants • The participants analyzed include all participants who completed the baseline survey.
Organizational Readiness for Change Scale	—	53.78 units on a scale STANDARD_DEVIATION 7.45 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey (N=36). The patient participants were not asked to answer this measure.	53.78 units on a scale STANDARD_DEVIATION 7.45 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey (N=36). The patient participants were not asked to answer this measure.
Acceptability of Intervention Measure	—	4.47 units on a scale STANDARD_DEVIATION 0.58 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.	4.47 units on a scale STANDARD_DEVIATION 0.58 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.
Intervention Appropriateness Measure	—	4.42 units on a scale STANDARD_DEVIATION 0.58 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.	4.42 units on a scale STANDARD_DEVIATION 0.58 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.
Feasibility of Intervention Measure	—	4.38 units on a scale STANDARD_DEVIATION 0.62 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.	4.38 units on a scale STANDARD_DEVIATION 0.62 • n=36 Participants • The participants analyzed include all practitioners who completed the baseline survey. The patient participants were not asked to answer this measure.

Measure	Electric Toothbrush Patients n=710 participants at risk Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and an electric toothbrush.	Nicotine Replacement Therapy Patients n=486 participants at risk Participants will receive the Ask-Advise-Refer intervention which includes an oral health practitioner asking about their tobacco use, advising them to quit smoking, and referring them to the state quitline. They will also receive a sample bag including information about smoking and oral health, the state quitline, and a two week supply of 14mg nicotine patches and 4mg lozenges.
Gastrointestinal disorders Dry mouth at 1M	31.1% 221/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	25.3% 123/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Dry mouth at 3M	28.7% 204/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	25.1% 122/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Dry mouth at 6M	26.2% 186/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	20.2% 98/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Jaw soreness at 1M	10.7% 76/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	9.9% 48/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Jaw soreness at 3M	10.1% 72/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	8.8% 43/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Jaw soreness at 6M	8.5% 60/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	6.0% 29/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Excessive saliva at 1M	6.3% 45/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.2% 35/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Excessive saliva at 3M	9.0% 64/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.6% 37/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Excessive saliva at 6M	7.0% 50/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	6.2% 30/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Insomnia at 1M	35.4% 251/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	30.2% 147/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Insomnia at 3M	35.4% 251/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	26.1% 127/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Insomnia at 6M	30.0% 213/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	25.7% 125/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Hiccups at 1M	8.2% 58/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.4% 36/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Hiccups at 3M	9.7% 69/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	9.7% 47/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Hiccups at 6M	8.5% 60/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	9.7% 47/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Burning in throat at 1M	6.5% 46/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	6.8% 33/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Burning in throat at 3M	7.3% 52/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	8.6% 42/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Burning in throat at 6M	5.4% 38/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	8.2% 40/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin irritation at 1M	6.8% 48/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	8.2% 40/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin irritation at 3M	10.3% 73/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	9.5% 46/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin irritation at 6M	7.0% 50/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	10.5% 51/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin redness at 1M	4.2% 30/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.6% 37/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin redness at 3M	6.8% 48/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.8% 38/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Musculoskeletal and connective tissue disorders Skin redness at 6M	5.2% 37/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	9.3% 45/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Skin itchiness at 1M	10.3% 73/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	12.3% 60/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Skin itchiness at 3M	14.2% 101/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	11.9% 58/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Skin itchiness at 6M	10.4% 74/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	13.2% 64/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Nausea at 6M	16.9% 120/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	18.5% 90/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Headache at 1M	39.6% 281/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	34.4% 167/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Headache at 3M	39.3% 279/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	33.1% 161/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Headache at 6M	36.8% 261/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	29.4% 143/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Heartburn at 1M	26.3% 187/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	23.5% 114/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Heartburn at 3M	27.5% 195/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	23.7% 115/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Heartburn at 6M	24.2% 172/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	22.8% 111/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Mouth soreness at 1M	14.9% 106/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	12.8% 62/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Mouth soreness at 3M	11.8% 84/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	8.6% 42/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Mouth soreness at 6M	10.6% 75/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	7.6% 37/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Dizziness at 1M	21.0% 149/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	21.4% 104/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Dizziness at 3M	21.4% 152/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	20.4% 99/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Nervous system disorders Dizziness at 6M	20.6% 146/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	17.3% 84/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
Gastrointestinal disorders Nausea at 1M	15.1% 107/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	20.6% 100/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.
General disorders Nausea at 3M	18.7% 133/710 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.	21.2% 103/486 • from baseline to six-months Deaths or serious adverse events such as hospitalizations; adverse events were only systematically collected for patients.