Nicotine replacement therapy (NRT) sales switched from prescription to over-the-counter (OTC) in 1996. The change was expected to increase access to NRT. Industry data show a doubling in NRT sales since the switch, but whether it increased rates of use of NRT, quit attempts, and smoking cessation is unknown. We analyzed the Massachusetts Tobacco Surveys, telephone surveys of a probability sample of Massachusetts residents (response rates 68%-78%). We compared responses from 1784 past-year smokers in 1993 (pre-OTC) to those from 1240 past-year smokers in 1997-99 (post-OTC), using multiple logistic regression. There was no change over time in the proportion of respondents who used NRT at a quit attempt in the past year (20.1% pre-OTC vs. 19.9% post-OTC) and no change in the proportion who made a quit attempt or quit smoking. Half of smokers who used NRT post-OTC used it to "delay or cut down" their smoking rather than to make a quit attempt. Fewer non-whites used NRT after the switch (20.7% pre-OTC vs. 3.3% post-OTC, p=.002), but the proportion of whites using NRT did not change (21.9% vs. 20.6%). More 18-30 years-olds and fewer >45 year-olds used NRT post- compared to pre-OTC (p=.0004). We find no evidence that the OTC switch was associated with increased NRT use, quit attempts, or cessation rates. One explanation may be that many smokers purchased NRT for reasons other than cessation. There appear to be other barriers to NRT use beyond visiting a physician for a prescription, especially among older and minority smokers.
Learning Objectives: At the conclusion of this presentation, the learner will be able to describe the impact of switching nicotine replacement therapy to over-the-counter status on smoking cessation outcomes in Massachusetts
Keywords: Tobacco, Therapies
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.