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The demand for nicotine replacement therapies (NRT) is directly related to the level of health insurance coverage for NRT products, and inversely related to out-of-pocket costs.



Individuals who face no out-of-pocket costs for obtaining NRT products are more likely to use NRT, use NRT for longer periods of time, and subsequently use more units of NRT than individuals who face out-of-pocket costs. Over-the-counter  availability of nicotine gum and nicotine patches increased the proportion of smokers using the patch and gum in the period immediately following approval of over-the-counter sale in California; there was also a significantly higher proportion of smokers reporting abstinence through gum and patch use in that period. Making smokers aware of insurance coverage for a pharmacotherapy benefit (such as NRT, bupropion or varenicline) and making it very easy to obtain the medication, increases use of the medication and quit rates, even in the absence of insurance coverage for behavioral counseling. However, simply providing coverage for pharmacotherapy, without efforts to make smokers aware of the covered benefit and making it easy to obtain, was not shown to increase the use of medication and quit rates.



Curry SJ, Grothaus LC, McAfee T, Pabiniak C. Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization. N Engl J Med. 1998; 339 : 673-679.

Hughes JR, Wadland WC, Fenwick JW, Lewis J, Bickel WK. Effects of cost on the self administration and efficacy of nicotine gum: a preliminary study. Prev Med. 1991; 20: 486-496.

Reda AA, Kotz D, Evers SM, van Schayck CP. Healthcare financing systems for increasing the use of tobacco dependence treatment. Cochrane Database Syst Rev. 2012; 6: CD004305.pub4.

Solberg LI. Impact of insurance coverage on the use and effects of smoking cessation medications. Dis Manage Health Outcomes. 2005; 3(13): 151-158.

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