The Effect of Over-the-Counter Sales of the Nicotine Patch and Nicotine Gum on Smoking Cessation in California

Abstract

The Food and Drug Administration approved over-thecounter (OTC) sale of nicotine gum and nicotine patches in 1996. We used data from the 1996 California Tobacco Survey to compare the rates of nicotine replacement therapy (NRT) use and smoking abstinence in California for each month during a period immediately preceding and immediately following the OTC availability of nicotine gum and patches. For smokers eligible to report a quit attempt, the proportion making a quit attempt using NRT and the proportion remaining abstinent was calculated for each of the 12 months prior to the survey interview. Multiple regression modeling of quit attempts and abstinence included a term for the number of months between the quit attempt and survey interview and dummy variables for the months before and after the OTC availability of NRT. Results showed a significant increase in the fraction of smokers using the patch (P < 0.01) and gum (P < 0.05) immediately following their availability OTC. There was also a significantly higher proportion of smokers reporting abstinence with gum use (P < 0.01) and a significant increase in reported abstinence with patch use (P < 0.01) during the period of time immediately following the availability of these products without a prescription. The results of this study suggest that removing the prescription status of NRT products resulted in an immediate increase in quit attempts and smoking abstinence with the use of nicotine gum or patches.

The Effect of Cigarette Price Increases on Smoking Cessation in California

“…We modeled the rate of quit attempts and smoking abstinence for each month for a period of time preceding and following the increases in cigarette prices in California, while controlling for the potential confounding influences of recall bias (Gilpin and Pierce 1994), the increase in quits observed following the availability of OTC NRT (Reed et al 2005), and the increase in quitting behavior typically observed each January resulting from New Year's resolutions (Gritz et al 1988;Norcross et al 1989)…”

“…We calculated the proportion of smokers reporting a quit attempt (successful or unsuccessful) for each month from October 1995 to November 1996 and from September 1998 to October 1999 (see Reed et al 2005 for a detailed description). For each calendar month of the survey administration, we calculated a separate quit attempt and abstinence rate for the 10-month interval spanning 2 to 12 months prior to the month in which the survey data were collected.…”

“…We combined the 1996 and 1999 CTS datasets into a single dataset so that we could statistically control for the effect of increased cessation attributed to New Year's resolutions (Gritz et al 1988;Norcross et al 1989) as well as for the effect the availability of OTC NRT products had on quit attempts and abstinence (Reed et al 2005). Thus, our regression models included a term in representing the month of January for both surveys and two terms representing the months before and after nicotine gum (pre-OTC gum quits, November 1995-May 1996; post-OTC gum quits, June 1996-October 1999) and the nicotine patch (pre-OTC patch quits, November 1995-July 1996; post-OTC patch quits, August 1996-October 1999) went over the counter in 1996.…”

Quitline Cessation Counseling for Young Adult Smokers: A Randomized Clinical Trial

“…Although not originally a focus of the study, secondary analyses examined the relations of medication use with outcome because of conflicting findings about the effects of cessation medication in real-world contexts (e.g., Pierce and Gilpin, 2002;Reed, Anderson, Vaughn, & Burns, 2005). In our study, participants were not offered cessation medication but 72 of the 278 participants completing the 1-month follow-up reported using cessation medication.…”

Ten years after the Rx-to-OTC switch of nicotine replacement therapy: What have we learned about the benefits and risks of non-prescription availability?

“…Unlike the transient increase in utilization that marks many new prescription medications, this increased utilization appears to have been sustained [14], perhaps because of promotional campaigns. The increased utilization inferred from sales data has since been confirmed in population surveys [15][16][17] (though Table 1 Arguments for and against the Rx-to-OTC switch of NRT…”