257688 Geographic disparities in access to nonprescription nicotine replacement therapy in St. Louis pharmacies

Monday, October 29, 2012

Linda Jin , Dept of Surgery/Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO
Joaquin Barnoya, MD, MPH , Department of Surgery/Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO
Karen Hudmon, DrPH, MS, RPH , Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN
Shumei Yun, MD, PhD , Office of Epidemiology, Missouri Department of Health and Senior Services, Jefferson City, MO
Mario Schootman, PhD , Health Behavior Research, Washington University of St. Louis-School of Medicine, Saint Louis, MO
Background: Tobacco use and its consequences are more prevalent among the poor. Unequal access to cessation medications may in part explain this disproportionate burden. This study aims to compare the availability, advertising, and pricing of nicotine replacement therapy (NRT) and tobacco products in St. Louis pharmacies by neighborhood characteristics. Methods: Research assistants will visit pharmacies to assess the availability, advertising, and pricing of NRT, tobacco products, and electronic cigarettes in all 321 retail pharmacies in St. Louis City and County, MO. Zip codes will be classified by socioeconomic status (SES) and racial distribution from US census data, as well as smoking prevalence and quit attempts from the 2011 Missouri Department of Health and Senior Services survey. Using ArcGIS software, pharmacies will be analyzed by the SES, racial distribution, smoking prevalence and quit attempts of their corresponding zip code. Results: Data collection will be completed in April 2012. We hypothesize that pharmacies located in high SES and predominantly white zip codes will have higher availability of NRT compared to their low SES and African American counterparts. Regardless of zip code, we hypothesize that the cheapest tobacco product will be more frequently advertised and more accessible than the cheapest NRT product. Higher availability of NRT might be associated with higher quit attempts. Conclusions: NRT availability and accessibility are low compared to that of tobacco in St. Louis pharmacies. Low access to NRT further increases inequalities by SES and racial distribution. Our data will support policies to increase NRT access in all neighborhoods.

Learning Areas:
Chronic disease management and prevention
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
1. Evaluate the disparity in availability, accessibility, and advertising of nicotine replacement therapy medication and tobacco products in St. Louis, MO by neighborhood racial distribution and socioeconomic status. 2. Determine the association between quit attempts and neighborhood availability of nicotine replacement therapy. 3. Discuss the implications of pharmacies offering significantly easier access to tobacco products compared to nicotine replacement therapy on their role as a community-based public health advocate.

Keywords: Smoking Cessation, Measuring Social Inequality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator on this study and overseen the design and implementation of the project. Among my research interests are disparities in community access to healthcare and consumer protection in choosing health care options.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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