Increased Attempts to Quit Smoking Follow Introduction of Over-the-Counter Nicotine Replacement Therapies
SAVANNAH, Ga., Feb. 20 /PRNewswire/ -- Since nicotine replacement therapy (NRT) became available as a nonprescription treatment to help Americans stop smoking, the number of adults attempting to quit smoking significantly increased to nearly 40 percent, a
``In the same period that nicotine replacement therapies, such as the nicotine patch or nicotine gum, became available over-the-counter, we see more Americans trying to stop smoking,'' says study author Saul Shiffman, Ph.D., professor of psychology at the University of Pittsburgh. ``This may mean that the easier accessibility of OTC products has positively impacted U.S. public health. Of course, other smoking cessation efforts are certainly part of this success story, as well. It's a win-win situation for all Americans who want to lead healthier lives.''
Of the 48 million current adult U.S. smokers, approximately 70 percent -- some 34 million -- report they would like to stop smoking, and 1.2 million successfully quit permanently, according to the U.S. Centers for Disease Control and Prevention (CDC). The U.S. Food and Drug Administration (FDA) approved prescription-only NRT in the form of a chewing gum, NicoretteÂ®, in 1984 and a transdermal patch, NicoDermÂ®CQÂ®, in 1991. Both products help relieve smoking withdrawal symptoms by providing temporary, alternate nicotine sources to smoking, allowing a person to gradually reduce his or her dependence on nicotine, a quitting method recommended by physicians. The FDA reclassified the NRT gum and the patch as OTC products in 1996.
For the analysis, Shiffman and his colleagues used data from the National Cancer Institute's Tobacco Use Supplement to the Current Population Survey, conducted by the U.S. Census bureau in 1992-1993, 1995-1996 and 1998-1999. The supplement includes national and state data on smoking and other tobacco use in the U.S. population, based on a large, nationally representative sample of about 240,000 people.
In the 1999 survey, some 39.9 percent of adult American smokers (95 percent confidence interval: 39.1 to 40.6 percent) had attempted to quit smoking in the past year, the investigators found. This was a significant increase from 35.6 percent (34.9 to 36.4 percent) in 1996 and from 37.9 percent (37.2 to 38.6 percent) in 1993.
``The history of nicotine replacement products seems to parallel the numbers. Attempts to quit smoking spiked concurrent with the introduction of the nicotine patch in 1993, then declined as use of prescription-only products reached steady-state, as noted in the 1996 data. However, the 1999 data, from the post-OTC switch era, shows a significant increase in quitting behavior,'' explains coauthor Joe Gitchell, vice president at Pinney Associates.
Shiffman, Gitchell and their coauthors also analyzed quit attempt data from two states with comprehensive tobacco control programs, Massachusetts and California, finding no significant change in quitting behavior from 1993 to 1999. Both states had rates that hovered around 40-45 percent for each of the years (1993, 1996, and 1999); changes over time were not statistically significant.
``Both Massachusetts and California have very high annual rates of quit attempts, averaging near or at 50 percent, which are the highest in the United States. These high rates are a testimony to their consistent application of comprehensive anti-smoking programs, which include NRT and other approaches to help smokers stop. In these already-active states, we don't see the bar being pushed further,'' notes Shiffman.
In addition to NRT, Massachusetts and California encourage smoking cessation by controlling tobacco product advertising, encouraging anti-smoking advertising, increasing the prices of tobacco products, establishing and enforcing ``clean air'' laws that regulate smoking areas and offering cessation counseling.
The Census data analysis contributes to the understanding of quitting behavior and links with previous research findings that the availability of OTC NRT products and the introduction of new NRT products increased pharmacologically assisted attempts to stop smoking. Most notable was a 2000 study by the CDC published in the ``Morbidity and Mortality Weekly Report'' (MMWR).(1)
The ``MMWR'' study found the largest increases in NRT use coincided with the introduction of the nicotine patch and OTC switch and that the introduction of two newer NRT forms, a nasal spray and an oral inhaler, had almost no impact on use of treatments.
``The use of nicotine replacement patches and gum following their switch to OTC status has held steady, suggesting that smokers understand these products can help them quit smoking,'' says Shiffman.
GlaxoSmithKline Consumer Healthcare, marketers of NicoretteÂ® and NicoDermÂ®CQÂ®, sponsored the consensus analysis, and Shiffman and Gitchell provide consulting services on their behalf. GlaxoSmithKline originated the OTC NRT category with the FDA approval of OTC NicoretteÂ® and continues to lead the market after the introduction of the original OTC NicoDermÂ®CQÂ® patch and the launch of OTC NicoretteÂ® Mint, NicoretteÂ® Orange and Clear(TM) NicoDermÂ®CQÂ®. For more information about the latest stop smoking aids, visit http://www.quitnet.net.
GlaxoSmithKline -- one of the world's leading research-based pharmaceutical and healthcare companies -- is committed to improving the quality of human life by enabling people to do more, feel better and live longer.