Does over-the-counter nicotine replacement therapy improve smokers' life expectancy?

Area of Science:

• Public Health
• Health Policy
• Smoking Cessation

Background:

• Nicotine replacement therapy (NRT) is a key tool for smoking cessation.
• Current NRT availability is primarily prescription-based in the United States.
• The impact of over-the-counter (OTC) NRT on public health outcomes requires detailed assessment.

Purpose of the Study:

• To evaluate the public health benefits of making NRT available OTC.
• To quantify the projected increase in successful quitters.
• To estimate the impact on life expectancy and smoking-attributable mortality (SAM).

Main Methods:

• A decision-analytic model was employed to compare OTC versus prescription NRT availability.
• The model focused on the adult smoking population in the United States.
• Key outcome measures included six-month quit rates, life expectancy, and SAM rates.

Main Results:

• OTC NRT is projected to yield approximately 1.7 million additional quitters over 25 years.
• Annual smoking-attributable deaths are estimated to decrease by 348 at six months and 2940 at five years.
• An average gain in life expectancy of 0.196 years per smoker is associated with OTC NRT availability.

Conclusions:

• OTC availability of NRT is associated with a substantial increase in successful quitters compared to prescription-only access.
• The policy change is predicted to reduce smoking-attributable deaths and enhance life expectancy among smokers.
• Sensitivity analyses confirmed the robustness of these public health benefits across various parameter changes.