title: Using policy to increase prescribing of smoking cessation medications in the VA healthcare system.
abstract: BACKGROUND
  Since 2002 the US Veterans Affairs (VA) healthcare system has initiated national policies and programmes to reduce smoking among its patients and to increase evidence-based treatment for smoking.
  
  
  OBJECTIVE
  To document changes in dispensing rates of cessation-related medications in VA from 2004 to 2008.
  
  
  METHODS
  Retrospective analysis of VA administrative data.
  
  
  RESULTS
  Prescription fills for nicotine replacement therapy (NRT), and for bupropion among NRT users, each grew more than 60% in four years. The increase stemmed primarily from treating more people rather than from filling more prescriptions per person.
  
  
  CONCLUSIONS
  The results provide strong support for the efficacy of these policies and illustrate how healthcare systems can successfully employ multiple strategies to increase evidence-based smoking-cessation treatment.
authors.affiliation: Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California 94025, USA. mark.smith9@va.gov
authors.forename: Mark W
authors.initials: MW
authors.lastname: Smith
authors.forename: Shuo
authors.initials: S
authors.lastname: Chen
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Siroka
authors.forename: Kim
authors.initials: K
authors.lastname: Hamlett-Berry
mesh_terms: D016642:Bupropion / Q000627:therapeutic use*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D006291:Health Policy; D006801:Humans; D009538:Nicotine / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D055656:Prescriptions / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*
chemical_list: D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine