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Using policy to increase prescribing of smoking cessation medications in the VA healthcare system
  1. Mark W Smith1,2,
  2. Shuo Chen1,
  3. Andrew M Siroka1,
  4. Kim Hamlett-Berry3
  1. 1Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA
  2. 2Center for Primary Care and Outcomes Research, Stanford Medical School, Stanford, California, USA
  3. 3Office of Public Health Policy and Prevention, Public Health Strategic Health Care Group, US Department of Veterans Affairs, Washington, District of Columbia, USA
  1. Correspondence to Mark W Smith, Health Economics Resource Center, VA Palo Alto Health Care System 650-617-2630, 795 Willow Rd 152 MPD, Menlo Park, CA 94025, USA; mark.smith9{at}


Background Since 2002 the US Veterans Affairs (VA) healthcare system has initiated national policies and programmes to reduce smoking among its patients and to increase evidence-based treatment for smoking.

Objective To document changes in dispensing rates of cessation-related medications in VA from 2004 to 2008.

Design Retrospective analysis of VA administrative data.

Results Prescription fills for nicotine replacement therapy (NRT), and for bupropion among NRT users, each grew more than 60% in four years. The increase stemmed primarily from treating more people rather than from filling more prescriptions per person.

Conclusion The results provide strong support for the efficacy of these policies and illustrate how healthcare systems can successfully employ multiple strategies to increase evidence-based smoking-cessation treatment.

  • Tobacco use disorder
  • smoking cessation
  • nicotine polacrilex
  • bupropion
  • performance measures
  • Veterans Hospitals/economics
  • cessation
  • economics
  • health services
  • nicotine products
  • public policy

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  • Funding was provided by the Cooperative Studies Program of the Clinical Science Research and Development Service, US Department of Veterans Affairs (CSP #519). The views expressed here are those of the authors and not necessarily those of the US Department of Veterans Affairs.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Palo Alto VA R&D Committee and Stanford University IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.