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
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of smoking-cessation services under four insurance plans in a
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