Oster G, Delea T E, Huse D M, Regan M M, Colditz G A
Policy Analysis Inc., Brookline, MA 02146, USA.
Med Care. 1996 May;34(5):389-402. doi: 10.1097/00005650-199605000-00002.
Nicotine polacrilex ("nicotine gum") is effective in helping persons to quit smoking cigarettes. Because many persons try to quit without formal assistance, it may be an appropriate product for over-the-counter (OTC) purchase. Some smokers, however, might use such a product in lieu of more effective methods of cessation, and still others might use it to cope with enforced periods of nicotine abstinence (eg, at the work place) and thereby delay their decision to quit. The study's objective was to assess the public health benefits and risks of OTC availability of nicotine gum. A Markov model was developed and used to contrast two alternative policy scenarios: one in which nicotine gum was assumed to remain available only by prescription, and another in which it was assumed to be made available for OTC purchase. Various data sources were used to estimate the model, including the Health Promotion and Disease Prevention Supplement to the 1991 National Health Interview Survey and the 1986 Adult Use of Tobacco Survey. Primary outcome measures included the numbers of persons who would try to quit smoking, the numbers who would use various methods of smoking cessation, including OTC nicotine gum, and the numbers of current adult smokers who would be abstinent at the end of 10 years. Findings suggest that an average of 3 million persons each year would use OTC nicotine gum. As a consequence of OTC availability, an additional 450,000 smokers would be abstinent at the end of 10 years. These results are sensitive to assumptions regarding the effectiveness of OTC nicotine gum, as well as to the effect of OTC availability on the use of other methods of smoking cessation. The number of persons who would quit smoking, however, increases under a fairly wide range of assumptions. Over-the-counter availability of nicotine gum may confer significant public health benefits.
尼古丁咀嚼胶（“尼古丁口香糖”）有助于人们戒烟。由于许多人试图在没有正规帮助的情况下戒烟，它可能是一种适合非处方（OTC）购买的产品。然而，一些吸烟者可能会使用这种产品来替代更有效的戒烟方法，还有一些人可能会用它来应对强制戒烟期（如在工作场所），从而推迟他们戒烟的决定。该研究的目的是评估尼古丁口香糖非处方销售对公众健康的益处和风险。开发了一个马尔可夫模型，并用于对比两种替代政策情景：一种情景假设尼古丁口香糖仍仅凭处方可得，另一种情景假设它可用于非处方购买。使用了各种数据源来估计该模型，包括《1991年全国健康访谈调查健康促进与疾病预防增刊》和《1986年成人烟草使用调查》。主要结局指标包括试图戒烟的人数、使用各种戒烟方法（包括非处方尼古丁口香糖）的人数，以及在10年末戒烟的成年吸烟者人数。研究结果表明，平均每年有300万人会使用非处方尼古丁口香糖。由于非处方销售，在10年末将多45万吸烟者戒烟。这些结果对有关非处方尼古丁口香糖有效性的假设以及非处方销售对其他戒烟方法使用的影响很敏感。然而，在相当广泛的假设下，戒烟的人数会增加。尼古丁口香糖的非处方销售可能会带来显著的公众健康益处。
