Utilization and adherence to smoking cessation pharmacotherapy: A population-based study in Spain
Raúl Majo García1, Alfonso Díaz Madero2, Cristina Díez Flecha3
1Centro de Salud de Astorga, Gerencia Atención Primaria de León, Gerencia Regional de Salud Castilla y León (SACYL), C/ Gaspar Becerra s/n, Astorga, CP 24700, León, Spain.
Atencion Primaria
|May 13, 2026
Summary
Publicly funded smoking cessation pharmacotherapy use is limited, with low treatment completion rates. Improving follow-up strategies is crucial for better outcomes and equitable access to smoking cessation programs.
Area of Science:
- Public Health
- Pharmacotherapy Research
- Health Services Research
Background:
- Smoking cessation pharmacotherapy is a key public health intervention.
- Understanding the real-world utilization and adherence is essential for program optimization.
Purpose of the Study:
- To analyze the utilization of publicly funded smoking cessation pharmacotherapy.
- To determine the completion rates of recommended treatment regimens.
Main Methods:
- Retrospective population-based study in the Castilla y León public health system (Spain).
- Analysis of reimbursed varenicline, bupropion, and cytisinicline use from 2020-2024.
- Indirect estimation of adherence through treatment completion rates.
Main Results:
- 57,820 individuals (14.5% of smokers) used pharmacotherapy for 67,255 quit attempts.
- Overall utilization was limited; adherence to longer regimens was suboptimal.
- Treatment completion rates: 26.8% for varenicline, 32.4% for bupropion. Cytisinicline predominated. Women showed slightly better adherence.
Conclusions:
- Smoking cessation pharmacotherapy use in clinical practice is limited.
- Suboptimal treatment completion and disparities by sex and socioeconomic status necessitate improved follow-up.
- Enhanced strategies are needed to improve equity and accessibility in publicly funded cessation programs.
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