期刊
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
卷 49, 期 2, 页码 188-198出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amepre.2015.03.001
关键词
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资金
- Canadian Institutes for Health Research New Investigator Award
- Canadian Cancer Society Research Institute Junior Investigator Research Award
- NIH Grant [1 P01 CA138-389-01]
- Propel Centre for Population Health Impact
- Health Canada
- NATIONAL CANCER INSTITUTE [P01CA138389] Funding Source: NIH RePORTER
Introduction: In 2000, Quebec began reimbursing stop-smoking medications (SSMs) through their provincial public drug insurance plan. Several other Canadian provinces have since begun offering SSM subsidies. Clinical trials indicate that SSMs can increase quit success; however, little evidence exists on patterns of use in real-world settings and impact on population quit rates. This study examines Canadian trends in SSM use and quit success over time, comparing provinces with differing subsidization policies. Methods: Secondary analyses were conducted in 2014 using nationally representative Canadian Tobacco Use Monitoring Survey data, 2004-2012, for current and former smokers who made a quit attempt in the past 2 years (N=26,094). Regression models tested for differences in SSM use and quit success in provinces with differing SSM coverage (i.e., none, partial, or comprehensive). Results: Smokers were more likely to use nicotine replacement therapy (NRT) in jurisdictions with comprehensive SSM coverage versus jurisdictions with partial (OR=1.39, 95% CI=1.22, 1.59) or no coverage (OR=1.43, 95% CI=1.21, 1.68). Prescription medication use was more likely in provinces with partial (versus no) coverage (OR=1.27, 95% CI=1.01, 1.59). Overall, smokers who attempted to quit were more likely to remain abstinent in jurisdictions with comprehensive versus partial (OR=1.20, 95% CI=1.12, 1.28) or no coverage (OR=1.23, 95% CI=1.00, 1.50). An interaction between coverage and cigarettes per day was observed, suggesting potentially greater impact of comprehensive coverage among heavier smokers. Conclusions: Comprehensive subsidization policies are associated with modest increases in NRT use and quit success, but do not appear to impact prescription SSM use. (C) 2015 American Journal of Preventive Medicine
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