POPULATION TRENDS IN SMOKING CESSATION AND CORRELATIONS TO PHARMACOTHERAPY UTILIZATION: RESULTS FROM THE CURRENT POPULATION SURVEY Open Access
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We evaluated whether the epidemiological trend data on smoking cessation activity are consistent with trends in sales of smoking cessation pharmacotherapies, nationally and in States with leading tobacco control initiatives. Analyses were made across four eras of nicotine replacement therapy (NRT) medication usage: 1) Introduction of the nicotine patch by prescription (Rx) in 1992; 2) "Steady state" utilization of Rx NRT era from 1994 to early 1996; 3) NRT "over the counter" (OTC) era beginning in 1996; and 4) "Steady-state" OTC NRT era beginning in 2003. We examined self-reported past-year smoking cessation activity of adult smokers responding to the Tobacco Use Supplement to the Current Population Survey from 1992 to 2003. The analysis population included a total of 50,585 for 1992, 26,968 for 1995, 35,125 for 1998, and 31,136 for 2003, representative of 41.6 million, 40.7 million, 39.9 million, and 35.6 million past-year smokers, respectively. We evaluated rates of smoking cessation attempted, successful smoking cessation and longest duration of maintained abstinence during the past year using logistic regression and survival analyses, while controlling for the influence of public policy changes across time. Mirroring NRT sales data, there was high quitting activity in the initial Rx NRT era (1992), followed by a decline in quitting activity during the "steady state" Rx NRT era (1995) and subsequent increase in smoking cessation activity during the OTC NRT era (1998). However, while the smoking cessation activity during the OTC NRT era provides corresponding support for the hypothesis of widened access leading to increased smoking cessation activity, the findings from this research are minimal to support a sustained effect subsequent to the OTC NRT era, as data from the "steady state" OTC NRT era show a comparative reduction in all smoking cessation activity when compared to the OTC NRT era. Although this research has several limitations which should kept in mind during interpretation of presented results, it is the first to examine the temporal trends in smoking cessation activity for the U.S. over this historical period.