Nicotine Replacement Therapy (NRT) products are FDA-approved aids for smoking cessation. Despite their effectiveness, little is known about NRT sales trends and seasonal fluctuations in demand. This study examined sales of nicotine patches, gums, and lozenges in the U.S., focusing on patterns before and after the introduction and rise of e-cigarettes.

Methods

Weekly sales data for nicotine patches, gums, and lozenges during 2006-2020 were sourced from NielsenIQ-Kilts, covering over 90 U.S. retail chains. Total sales (USD) and nicotine content (million mg) were calculated for each product type, with data adjusted for inflation using the consumer price index. Seasonal and Trend decomposition using LOESS (STL) was utilized to analyze seasonal trends and ANOVA to assess significant seasonal differences.

Results

Total NRT sales peaked in 2007 ($239.88 million) and were lowest in 2014 ($166.72 million). The highest nicotine content was 1,205.25 million mg in 2018, and the lowest was 931.55 million mg in 2010. Nicotine gum consistently led sales, holding over 60% market share. Seasonal trends showed the highest nicotine content sold in Winter (mean=281.35; sd=25.82) and Spring (mean=273.59; sd=15.85) (F=3.678; p=0.012). Despite this, only nicotine patches showed significant seasonal fluctuations in nicotine content (F=5.89; p=0.001). Nicotine gum exhibited a steady upward trend until 2018, with pronounced seasonal peaks early in the year, while lozenges declined sharply until 2014 before partially recovering the trend. Nicotine patches displayed a persistent downward trend with minimal seasonal variation. No significant sales differences were found for all products across seasons (F=1.463; p=0.235).

Conclusion

NRT sales showed a decline, with changes tied to the rise of e-cigarettes and debates over their risks and benefits. Smokers tend to attempt to quit more often in Winter and Spring, with e-cigarettes likely affecting the demand for NRT. Public health strategies should consider these seasonal trends to improve cessation efforts.