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    Pharmaceutical Assistance Programs (PAPs) helped some low-income, rural smokers access cessation medications. However, access and utilization remained lower compared to insured individuals, highlighting ongoing barriers to smoking cessation for vulnerable populations.

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    Area of Science:

    • Public Health
    • Health Services Research
    • Addiction Medicine

    Background:

    • Rural smokers face significant financial barriers to accessing smoking cessation medications due to higher rates of poverty and lack of insurance.
    • Pharmaceutical Assistance Programs (PAPs) offer a potential solution to improve medication access for low-income populations.
    • Understanding the effectiveness of PAPs in this demographic is crucial for developing targeted interventions.

    Purpose of the Study:

    • To assess the effectiveness of a system designed to connect low-income, rural smokers with Pharmaceutical Assistance Programs (PAPs) for smoking cessation medications.
    • To evaluate medication utilization and smoking abstinence rates among eligible participants in a randomized clinical trial.

    Main Methods:

    • A randomized clinical trial involving rural smokers tested telemedicine versus telephone-based counseling.
    • A system was implemented to assist eligible participants in applying for PAPs to obtain low-cost smoking cessation medications.
    • Medication utilization was reported at 3 and 6 months post-randomization.

    Main Results:

    • Over half of the participants (55.7%) were eligible for PAPs, but only 15.7% successfully obtained medications.
    • Medication use was significantly lower in PAP-eligible participants (51.3%) compared to those with insurance (60.4%).
    • Smoking abstinence rates at 3 months were lower for PAP-eligible smokers, though this difference diminished at later follow-ups.

    Conclusions:

    • While PAPs can facilitate access to smoking cessation medications for some low-income, uninsured smokers, significant barriers persist.
    • Overall access and utilization of cessation medications remain suboptimal for this population compared to those with insurance.
    • Further strategies are needed to overcome remaining challenges in medication access for vulnerable smoking populations.