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Smokers Prefer to Quit Without Help

Kate Traynor

Most of the 18-19 million Americans who try to quit smoking cigarettes each year don't take advantage of proven pharmacologic aids.

A report in the July 28 Morbidity and Mortality Weekly Report estimates the number of times smokers used FDA-approved smoking-cessation aids during 1984-1998. 

Fewer than 2 million "quit attempts" took advantage of pharmacologic cessation aids from 1984 through 1991, when prescription nicotine gum was the only product available. A quit attempt was defined as the first purchase of a unique smoking-cessation aid in a calendar year; a subsequent purchase of the same product in the same year was not counted. 

In 1992 the prescription nicotine patch was introduced to U.S. smokers and used in over 6 million quit attempts. Use of the patch declined to under 3 million quit attempts the following year, and remained low until the product became available without a prescription in 1996. 

Overall, heavy initial use of a newly marketed smoking aid was followed by a sudden drop in use of the product. An editorial note accompanying the article suggests that this pattern may be due to disillusionment by physicians and patients who had high initial hopes for the therapy. More realistic expectations along with nonprescription availability of these products could account for the increase in their use after 1995. 

In 1997 and 1998, about 8 million quit attempts were made by smokers using nicotine inhalers, nasal sprays, patches, or gum or bupropion tablets. In general, as more products became available, their use by consumers increased. 

Will this trend continue? The Business Journal in Research Triangle Park, N.C., recently reported that sales of Zyban, GlaxoWellcome Inc.'s bupropion product marketed specifically for smoking cessation, dropped 22 percent over the past year. According to the article, sales of Novartis Pharmaceutical Corp.'s prescription Habitrol patch dropped 43 percent, and sales of the nonprescription NicoDerm patch, from SmithKline Beecham, fell 20 percent. 

PCS Health Systems Inc. and National Data Corp. provided the data on prescription drug use for the MMWR study. Sales data on nonprescription smoking-cessation aids was obtained from ACNielsen, which relied on Universal Product Code (UPC) scanners in 10,000 community pharmacies and stores. Product sales from pharmacies without UPC scanners were estimated for the study. Quit attempts with nonprescription products were estimated from a sample of 40,000 households. 


New Guideline on Tobacco Cessation Available 

A new Public Health Service guideline, "Treating Tobacco Use and Dependence," addresses consumers' use of cigarettes and other tobacco products. As a result of ASHP's efforts, the guideline lists pharmacists among the primary care clinicians who can help patients kick the tobacco habit. The guideline and related material are available from the Surgeon General's Web site. Additional information on the pharmacist's role in smoking cessation can be found in the "ASHP Therapeutic Position Statement on Smoking Cessation," (PDF) published in 1999.