Skip to main content
NCBI home page
Tobacco Control logoLink to Tobacco Control
. 2005 Jun;14(3):166–171. doi: 10.1136/tc.2004.008649

Impact of UK policy initiatives on use of medicines to aid smoking cessation

R West 1, M DiMarino 1, J Gitchell 1, A McNeill 1
PMCID: PMC1748027  PMID: 15923466

Abstract

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.

Full Text

The Full Text of this article is available as a PDF (83.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balfour David J. K. Neuroplasticity within the mesoaccumbens dopamine system and its role in tobacco dependence. Curr Drug Targets CNS Neurol Disord. 2002 Aug;1(4):413–421. doi: 10.2174/1568007023339076. [DOI] [PubMed] [Google Scholar]
  2. Boer R., de Koning H., Threlfall A., Warmerdam P., Street A., Friedman E., Woodman C. Cost effectiveness of shortening screening interval or extending age range of NHS breast screening programme: computer simulation study. BMJ. 1998 Aug 8;317(7155):376–379. doi: 10.1136/bmj.317.7155.376. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boyle Raymond G., Solberg Leif I., Magnan Sanne, Davidson Gestur, Alesci Nina L. Does insurance coverage for drug therapy affect smoking cessation? Health Aff (Millwood) 2002 Nov-Dec;21(6):162–168. doi: 10.1377/hlthaff.21.6.162. [DOI] [PubMed] [Google Scholar]
  4. Burton S. L., Gitchell J. G., Shiffman S., Centers for Disease Control and Prevention (CDC) Use of FDA-approved pharmacologic treatments for tobacco dependence--United States, 1984-1998. MMWR Morb Mortal Wkly Rep. 2000 Jul 28;49(29):665–668. [PubMed] [Google Scholar]
  5. Ferry Linda Hyder. The power of the press in smokers' attempts to quit. BMJ. 2002 Jun 8;324(7350):1346–1347. doi: 10.1136/bmj.324.7350.1346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hajek P., West R., Foulds J., Nilsson F., Burrows S., Meadow A. Randomized comparative trial of nicotine polacrilex, a transdermal patch, nasal spray, and an inhaler. Arch Intern Med. 1999 Sep 27;159(17):2033–2038. doi: 10.1001/archinte.159.17.2033. [DOI] [PubMed] [Google Scholar]
  7. Hughes John R., Keely Josue, Naud Shelly. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004 Jan;99(1):29–38. doi: 10.1111/j.1360-0443.2004.00540.x. [DOI] [PubMed] [Google Scholar]
  8. Jarvis Martin J. Monitoring cigarette smoking prevalence in Britain in a timely fashion. Addiction. 2003 Nov;98(11):1569–1574. doi: 10.1046/j.1360-0443.2003.00528.x. [DOI] [PubMed] [Google Scholar]
  9. Pierce John P., Gilpin Elizabeth A. Impact of over-the-counter sales on effectiveness of pharmaceutical aids for smoking cessation. JAMA. 2002 Sep 11;288(10):1260–1264. doi: 10.1001/jama.288.10.1260. [DOI] [PubMed] [Google Scholar]
  10. Silagy C., Lancaster T., Stead L., Mant D., Fowler G. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2002;(4):CD000146–CD000146. doi: 10.1002/14651858.CD000146. [DOI] [PubMed] [Google Scholar]
  11. Stead Lindsay F., Davis Ronald M., Fiore Michael C., Hatsukami Dorothy K., Raw Martin, West Robert. Effectiveness of over-the-counter nicotine replacement therapy. JAMA. 2002 Dec 25;288(24):3109–3110. doi: 10.1001/jama.288.24.3109-jlt1225-1-4. [DOI] [PubMed] [Google Scholar]
  12. Taylor Donald H., Jr, Hasselblad Vic, Henley S. Jane, Thun Michael J., Sloan Frank A. Benefits of smoking cessation for longevity. Am J Public Health. 2002 Jun;92(6):990–996. doi: 10.2105/ajph.92.6.990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. West R., McEwen A., Bolling K., Owen L. Smoking cessation and smoking patterns in the general population: a 1-year follow-up. Addiction. 2001 Jun;96(6):891–902. doi: 10.1046/j.1360-0443.2001.96689110.x. [DOI] [PubMed] [Google Scholar]
  14. West R., McNeill A., Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000 Dec;55(12):987–999. doi: 10.1136/thorax.55.12.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. West R., McNeill A., Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000 Dec;55(12):987–999. doi: 10.1136/thorax.55.12.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. West Robert. Bupropion SR for smoking cessation. Expert Opin Pharmacother. 2003 Apr;4(4):533–540. doi: 10.1517/14656566.4.4.533. [DOI] [PubMed] [Google Scholar]
  17. Zhu S., Melcer T., Sun J., Rosbrook B., Pierce J. P. Smoking cessation with and without assistance: a population-based analysis. Am J Prev Med. 2000 May;18(4):305–311. doi: 10.1016/s0749-3797(00)00124-0. [DOI] [PubMed] [Google Scholar]

Articles from Tobacco Control are provided here courtesy of BMJ Publishing Group

RESOURCES