Persistent use of nicotine replacement therapy: an analysis of actual purchase patterns in a population based sample.
BACKGROUND
In 1996, the US Food and Drug Administration (FDA) approved switching nicotine gum and patch from prescription to over-the-counter (OTC) status. Some expressed concerns that broader availability and lack of physician control might increase persistent use of nicotine replacement therapy (NRT)-that is, use beyond the period specified by the FDA approved label.


OBJECTIVE
To estimate the incidence of persistent use of OTC nicotine gum and patch for periods of > 3 months, > or = 6 months, > or = 12 months, and > or 24 months.


METHODS
Analysis of NRT purchase patterns in data from a population based panel of US households that electronically scanned all household purchases between January 1997 and March 2000.


METHODS
In a national panel of 40,000 US households, 2690 recorded NRT purchases.


RESULTS
Among 805 households that purchased nicotine gum, 2.3% of new purchase incidents led to continuous monthly purchase of gum for > or = 6 months. For nicotine patches (2050 households) the percentage was 0.9%. For both gum and patch, the incidence of persistent purchase dropped below 0.4% by 24 months. Allowing one month gaps within a "continuous" purchase run resulted in increased estimates (for gum: 6.7% for > or = 6 months and 1.0% for > or = 24 months; for patch: 1.7% for > or = 6 months and 0.05% for > or = 24 months).


CONCLUSIONS
Persistent use of nicotine gum and patch is very rare and has not increased with the transition to OTC use, despite removal of physician oversight.
Shiffman
S
S
Pinney Associates and University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. shiffman@pinneyassociates.com
Hughes
J R
JR
Pillitteri
J L
JL
Burton
S L
SL
D000279:Administration, Cutaneous; D002638:Chewing Gum; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D004366:Nonprescription Drugs / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention
D002638:Chewing Gum; D004366:Nonprescription Drugs; D009538:Nicotine