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Anne N. Thorndike, MD, MPH, Lois Biener, PhD and Nancy A. Rigotti, MD

Anne N. Thorndike and Nancy A. Rigotti are with the General Medicine Division, Tobacco Research and Treatment Center, Medical Services, Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, Mass. Lois Biener is with the Center for Survey Research, University of Massachusetts, Boston. Nancy A. Rigotti is also with the Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, Inc, Boston, Mass.

Correspondence: Requests for reprints should be sent to Anne N. Thorndike, MD, MPH, Massachusetts General Hospital, General Medicine Unit, S50-9, Boston, MA 02114 (e-mail: athorndike{at}partners.org).

Objectives. This study examined whether the change in nicotine replacement therapy sales from prescription to over the counter (OTC) status affected smoking cessation.

Methods. We used the 1993–1999 Massachusetts Tobacco Surveys to compare data from adult current smokers and recent quitters before and after the OTC switch.

Results. No significant change over time occurred in the proportion of smokers who used nicotine replacement therapy at a quit attempt in the past year (20.1% pre-OTC vs 21.4% post-OTC), made a quit attempt in the past year (48.1% vs 45.2%), or quit smoking in the past year (8.1% vs 11.1%). Fewer non-Whites used nicotine replacement therapy after the switch (20.7% pre-OTC vs 3.2% post-OTC, P = .002), but the proportion of Whites using nicotine replacement therapy did not change significantly (20.6% vs 24.0%).

Conclusions. We observed no increase in Massachusetts smokers' rates of using nicotine replacement therapy, making a quit attempt, or stopping smoking after nicotine replacement therapy became available for OTC sale. There appear to be other barriers to the use of nicotine replacement therapy besides visiting a physician, especially among minority smokers. (Am J Public Health. 2002;92:437–442)

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