Areas for further research

• Comprehensive economic assessments aimed at eliciting price and income elasticities of demand for NRT products should be conducted globally, especially in low- and middle-income countries.
• More cost-effectiveness and cost-benefit studies of NRT and of interventions using other pharmacotherapy. The evidence base should also be extended to developing countries where economic data are sparse or non-existent.
• The question of access should be explored from various perspectives (public health agency, societal, and provider) to elicit its effect on demand for and use of smoking cessation services and products.
• Ascertain whether the training and use of paraprofessionals in low- and middle- income countries as counselors (as opposed to doctors) is both effective and economically effective in helping smokers quit.
• Determine the effect of regulation of NRT and non-NRT products on innovation in the treatment of nicotine dependence.
• Determine the relative cost-effectiveness of over-the-counter (OTC) NRT versus prescription NRT with counseling.
• Determine whether the cost-effectiveness of the least resource-intensive smoking cessation interventions varies depending on socio-economic status.
• The distribution and mode of availability of NRT products should be analyzed to ascertain impacts on who tries to quit, how often and on success rates.
• Determine whether intervention effectiveness, costs and cost-effectiveness vary by frequency and intensity of tobacco use.
• Determine the relationship between higher nicotine dependence and price sensitivity.
• Determine the relationship between higher nicotine dependence and successful cessation.
• Determine the characteristics of those smokers for whom extending the duration of pharmacotherapy may promote achievement of abstinence and prevention of relapse.
• Determine whether wider availability of NRT promotes nicotine addiction among children and others not using tobacco products.