Key Researchers

  • Policies that make pharmacological and behavioral treatments more accessible and affordable, such as over-the-counter sale of nicotine replacement medications telephone "quitlines," and workplace cessation programs can increase their utilization.

    Several studies have demonstrated the effectiveness of interventions developed to make smoking treatments more accessible and affordable. For example, sales of nicotine medications for smoking cessation increased when they were made available as over-the-counter, as opposed to prescription-only, products.

    There is also emerging evidence that employer policies can play a role lowering smoking rates. These policies include banning smoking at work, linking health insurance premiums to smoking status, and providing easy access to cessation programs.

    Telephone "quitlines" that offer easy, instant access to information on how to quit smoking have been shown to be useful interventions for promoting smoking cessation. The advertising, word of mouth, and healthcare involvement associated with quitlines helps to stimulate quit attempts while increasing demand for and easy access to low cost treatments for tobacco cessation. Studies also show that smokers, especially younger adults, like the ability to access cessation assistance over the Internet.

    In addition, there is evidence that smokers are responsive to the cost of stop smoking interventions. Studies have found that more people will make use of proven treatment interventions if the cost is covered by insurance or treatment is available for free or at a discount.

    Increasing awareness of effective cessation treatments does not always guarantee greater utilization. But generally speaking, it will increase use, especially if consumers get repeatedly exposed to the information. For example, requiring cigarette manufacturers to print a national quitline number on cigarette packs has been found to be a cost-effective way to increase the number of tobacco users accessing the service.

    Alesci NL, Boyle RG, Davidson G, Solberg LI, Magnan S. Does a health plan effort to increase smokers’ awareness of cessation medication coverage increase utilization and cessation? American Journal of Health Promotion. 2004; 18(5):366-369.
    Borland R, Segan CJ, Livingston PM, Owen N. The effectiveness for callback counseling for smoking cessation: a randomized trial. Addiction. 2001;96(6):881-9.
    Burns ME, Bosworth TW, Fiore MC. Insurance coverage of smoking cessation treatment for state employees. American Journal of Public Health. 2004;94(8):1338-1340.
    Burns ME, Bosworth TW, Fiore MC. Insurance coverage of smoking cessation treatment for state employees. American Journal of Public Health. 2004;94(8):1338-1340.
    Burns ME, Rosenberg MA, Fiore MC. Use of a new comprehensive insurance benefit for smoking-cessation treatment. Prev Chronic Dis. 2005;2(4):A15.
    Cummings KM, Fix B, Celestino P, et al. Reach, Efficacy, and Cost-effectiveness of Free Nicotine Medication Giveaway Programs. Journal of Public Health Management and Practice. 2006; 12[1], 37-43.
    Curry SJ, Grothaus LC, McAfee T, Pabiniak C, M.S. Use and Cost Effectiveness of Smoking-Cessation Services under Four Insurance Plans in a Health Maintenance Organization. New England Journal of Medicine. 1998; 339(10):673-679.
    Halpern, MT, Dirani R.; Schmier JK. Impacts of a Smoking Cessation Benefit Among Employed Populations. Journal of Occupational & Environmental Medicine. 2007;49(1):11-21.
    Hyland A, Rezaishiraz A, Giovino G, Bauer JE, Cummings KM. The Impact of Over the Counter Nicotine Replacement Therapy on Smoking Cessation: Results from a 2001 Survey of COMMIT Cohort Members. Nicotine & Tobacco Research. 2005; 7(4):547-555.
    Keeler TE, Hu TW, Manning R, Marciniak MD, Ong M, Sung HY. The benefits of switching smoking cessation drugs to over-the-counter. Health Economics. 2002; 11(5):389-402.
    McAlister AL, Rabius V, Geiger A, Glynn TJ, Huang P, Todd R. Telephone assistance for smoking cessation: one year cost effectiveness estimations. Tobacco Control. 2004;13(1):85-6.
    McNeill A. Impact of UK policy initiative on use of medicines to aid smoking cessation. Tobacco Control. 2005; 14(3):166-171.
    Miller N, Frieden TR, Liu SY, et al. Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation. Lancet. 2005; 365:[9474], 1849-54.
    Moher M, Hey K, Lancaster T. Workplace interventions for smoking cessation (Cochrane Review). Cochrane Database Syst Rev. 2005, (2): CD003440.
    Stead LF, Lancaster T. Telephone counseling for smoking cessation (Cochrane Review). Cochrane Database Syst Rev. 2001;(2):CD002850.
    West R, DiMarino ME, Gitchell A, Strecher VJ, Shiffman S, West R. Randomized controlled trial of a web-based computer tailored smoking cessation program as a supplement to nicotine patch therapy. Addiction. 2005; 100:682-688.
    Tauras JA, Chaloupka FJ. The demand for nicotine replacement therapies. Nicotine & Tobacco Research 5(2):237-243, 2003.
    Willemsen MC, Simons C, Zeeman G. Impact of the new EU health warnings on the Dutch quit line. Tobacco Control. 2002; 11:381-2.
    Zhu S-H, Anderson C.M., Tedeschi G.J., et al. Evidence of real-world effectiveness of a telephone quitline for smokers. New England Journal of Medicine. 2002;347(14):1087-93.



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