Timberlake David S, Joensuu Johanna, Kurko Terhi, Rimpelä Arja H, Nevalainen Jaakko
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Program in Public Health, University of California, Irvine, United States.
Tob Induc Dis. 2019 May 3;17:39. doi: 10.18332/tid/108537. eCollection 2019.
Finland's success in achieving the goal of its tobacco endgame largely depends on rectifying deficiencies in the delivery of smoking cessation services. One such weakness, which has not been documented with empirical data, is misuse of nicotine replacement therapy (NRT). This study's objective was to examine purchase patterns of NRT for estimating improper use of the medication. The study was based on the assumption that duration of a purchase episode is indicative of either proper use or misuse of NRT.
The participants (n=728), who purchased at least one NRT product in 2016 (mostly gum/lozenge), were selected through enrollment in a large customer loyalty program in Finland (LoCard). Participants were categorized into one of five groups according to their longest purchase episode of NRT, defined by purchases made in consecutive, 4-week intervals.
Most participants, who did not adhere to NRT guidelines, either purchased the medication for too short (≤4 weeks, 63.5%) or too long (>24 weeks, 13.2%) of a purchase episode. Median purchases of NRT in the first month of use were one and four in the former and latter, respectively. In contrast to other groups, persistent users (>24 weeks) did not curtail purchases of NRT across several 4-week intervals, suggesting potential for dependence on NRT.
The observation that most purchase episodes were terminated prematurely is consistent with surveys reporting widespread NRT misuse. Given uncertainty of greater regulation of NRT sales through legislation, it would be prudent for Finnish retailers to promote proper use of the therapy.
芬兰在实现烟草控制目标方面的成功很大程度上取决于纠正戒烟服务提供方面的不足。尼古丁替代疗法（NRT）的滥用是其中一个尚未有实证数据记录的弱点。本研究的目的是检查NRT的购买模式，以估计该药物的不当使用情况。该研究基于这样一种假设，即购买疗程的持续时间表明NRT的使用是恰当还是不当。
通过参与芬兰一个大型客户忠诚度计划（LoCard），选取了在2016年购买至少一种NRT产品（主要是口香糖/含片）的参与者（n = 728）。根据他们最长的NRT购买疗程，参与者被分为五组之一，最长购买疗程由连续4周间隔内的购买情况定义。
大多数未遵守NRT指南的参与者，购买疗程过短（≤4周，63.5%）或过长（>24周，13.2%）。在前一组和后一组中，使用NRT第一个月的购买中位数分别为1次和4次。与其他组不同，持续使用者（>24周）在几个4周间隔内并未减少NRT的购买，这表明存在对NRT产生依赖的可能性。
大多数购买疗程过早结束这一观察结果与报告NRT广泛滥用的调查结果一致。鉴于通过立法对NRT销售加强监管存在不确定性，芬兰零售商促进该疗法的正确使用将是审慎之举。
