Does over-the-counter nicotine replacement therapy improve smokers' life expectancy?
OBJECTIVE
To determine the public health benefits of making nicotine replacement therapy available without prescription, in terms of number of quitters and life expectancy.


METHODS
A decision-analytic model was developed to compare the policy of over-the-counter (OTC) availability of nicotine replacement therapy with that of prescription ([symbol: see text]) availability for the adult smoking population in the United States.


METHODS
Long-term (six-month) quit rates, life expectancy, and smoking attributable mortality (SAM) rates.


RESULTS
OTC availability of nicotine replacement therapy would result in 91,151 additional successful quitters over a six-month period, and a cumulative total of approximately 1.7 million additional quitters over 25 years. All-cause SAM would decrease by 348 deaths per year and 2940 deaths per year at six months and five years, respectively. Relative to [symbol: see text] nicotine replacement therapy availability, OTC availability would result in an average gain in life expectancy across the entire adult smoking population of 0.196 years per smoker. In sensitivity analyses, the benefits of OTC availability were evident across a wide range of changes in baseline parameters.


CONCLUSIONS
Compared with [symbol: see text] availability of nicotine replacement therapy, OTC availability would result in more successful quitters, fewer smoking-attributable deaths, and increased life expectancy for current smokers.
Lawrence
W F
WF
Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA. lawrencw@gunet.georgetown.edu
Smith
S S
SS
Baker
T B
TB
Fiore
M C
MC
D000328:Adult; D000368:Aged; D003198:Computer Simulation; D003663:Decision Trees; D004335:Drug and Narcotic Control; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use*; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014481:United States
D004366:Nonprescription Drugs; D009538:Nicotine