Context: Increasing the use of effective smoking cessation aids could in principle have a substantial public health impact. The UK government has undertaken several major policy initiatives to try to increase usage of smoking cessation medicines. It is important to evaluate what effect, if any, these have had to inform future policy in the UK and internationally.
Objective: This study used sales data to examine the impact of government initiatives to increase access to smoking cessation medicines.
Design: Information about prescription and non-prescription sales (1999–2002) was obtained. Estimates of utilisation were compared with findings from the Office of National Statistics (ONS) omnibus surveys. The effects of policy initiatives (making the medicines reimbursable and making them available on general sale outside pharmacies) were assessed by means of time series analysis. In addition a new nicotine replacement therapy (NRT) product (a nicotine lozenge) was launched and the effect of this on total utilisation was assessed.
Results: Making bupropion, and subsequently nicotine replacement therapy (NRT), reimbursable had a major impact in medication usage; the estimated increase in each case was more than 80 000 “treatment weeks” purchased per month. In addition, introduction of a nicotine lozenge increased total utilisation and did not detract from usage of other medicines. According to both the sales and the survey data, the proportion of smokers using medicines to aid smoking cessation more than doubled from 8–9% in 1999 to 17% in 2002. The ONS surveys showed no increase in the proportions of smokers making quit attempts and so the effects were solely on the proportions of quit attempts that were aided by medication.
Conclusions: In the UK, making smoking cessation medicines reimbursable led to a large increase in utilisation. While the effect on smoking prevalence would be too small to be detected in national surveys it could have a substantial public health impact.
- nicotine replacement therapy
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Competing interests: Robert West has undertaken research and consultancy for manufacturers of stop-smoking products; he has received honoraria, travel funds, and hospitality from these companies. Robert West has applied for a patent for a new nicotine replacement product. Ann McNeill has received travel funds and hospitality from manufacturers of stop-smoking products. Joe Gitchell and Michael DiMarino, through Pinney Associates, undertake consultancy for GSK who manufacture nicotine replacement therapies and bupropion. Joe Gitchell has a financial interest in development of novel nicotine replacement products. This study was originated by Ann McNeill who approached GSK for assistance with it; neither she nor Robert West received payment for their work on it.
Robert West is supported by a grant from Cancer Research UK.