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Smoking cessation category looks over the counter to kick butts

BY Sandra Levy

NEW YORK —The Family Smoking Prevention and Tobacco Control Act recently signed by President Obama is expected to lead to a decline in smoking and an increase in quit attempts, according to the Congressional Budget Office. And given the Food and Drug Administration’s recent mandate that prescription smoking cessation drugs Chantix (varenicline) and Zyban (bupropion hydrochloride) carry black-box warnings on the potential risks of psychiatric problems, the nonprescription smoking cessation aids category may get a boost.

According to Nielsen, sales of over-the-counter smoking-cessation products have increased as new federal and state taxes have boosted the price of a pack of cigarettes to $10 or more. In the most recent four-week period ended May 16, dollar sales of the aids rose 18.9% over the same period in 2008.

Smoking-cessation expert Saul Shiffman, professor of psychology at the University of Pittsburgh, believed the OTC category may see an upturn in sales. “Smokers may take another look at the OTCs. We hope people wouldn’t turn away from treatment, but if they are concerned about side effects, that they would turn to those medications which haven’t raised that concern,” Shiffman said.

Shiffman said consumers may be unaware that the new black-box warnings apply to prescription products and not to the OTCs. “As consumers become aware of that, you may see more people using OTC products. The hope is that people will not be discouraged from seeking medications to help them quit smoking,” Shiffman asserted.

Noting that the median number of quit attempts is about five, Shiffman said, “I suspect that is growing because the people who are left have a hard time quitting. Over 40% of smokers have made a quit attempt at least once in any given year. We know that people who have tried medications before are likely to try again.” Shiffman said he has seen people’s quit attempts fail because they didn’t use the medication properly or appropriately. “They don’t use enough of the gums and lozenges to get appropriate dosing, and they stop using the patch too soon,” he said.

Joel Zive, owner of Zive Pharmacy in Bronx, N.Y., said sales of OTC smoking aids may depend on what smokers’ insurance plans pay for. He also believed that Obama’s action and the black-box warnings may shake the smoking cessation category up and induce people to seek help.

Will more smokers try to quit? GlaxoSmithKline Consumer Healthcare’s Janet Carter-Smith, VP corporate development, said, “Certainly, in these economic times, many smokers are starting to reevaluate their addiction and trying to quit smoking for good. We know that most smokers (about 70%) want to quit, and research shows that policy changes, like an increase in the price of cigarettes or expansion of smoke-free laws, encourage many smokers to make quit attempts.” Carter-Smith said that the majority of smokers quit without the help of cessation tools, but only 3% to 5% are successful long term.

Finally, Fred Mayer, president of Pharmacists Planning Service Inc., pointed out that with 400,000 tobacco-related deaths per year, “smoking cessation is the easiest preventable cause of morbidity and mortality. Pharmacists can play a key role in getting patients to stop smoking,” he said.

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Washington, Mo., considers repealing recently passed PSE legislation

BY DSN STAFF

NEW YORK The objective here is closing down clandestine methamphetamine labs. The question is: Who is going to bear the cost? And the answer, ultimately, is the consumer.

It seems that one of the primary reasons behind legislation like this, which is also under consideration by the California state legislature as well as several local municipalities throughout Missouri, is cost shifting.

Indeed, one solution that would prevent the practice of “smurfing,” a practice whereby meth addicts exceed their legal purchase limits in pseudoephedrine products by buying across several nearby pharmacies, is electronic logbooking. By granting access to PSE logbooks to law enforcement in real time, law enforcement officers would not only be made aware of a “smurfer” as they were driving between pharmacies, but would also identify who that smurfer was and where they lived.

Setting up that comprehensive electronic logbooking system requires resources, however. State coffers have traditionally been tapped for that purpose, and at least in the case of California, the Consumer Healthcare Products Association has offered to help defray that cost. In the case of Missouri, more than $500,000 has already been earmarked for the implementation of an electronic logbooking system at the state level.

However,  a not-as-much-talked-about cost is also borne by law enforcement, as pointed out by Franklin County Sgt. Jason Grellner in Missouri. After all, it requires additional resources to actually apprehend and prosecute those criminals, he suggested. And a system that better defines who those criminals may be, by his estimation, could cost the state as much as $350,000 per criminal per year.

Therefore, Grellner argues, it’s a fiscal responsibility to take PSE off the OTC market altogether, and require a prescription for the popular decongestant.

That, in a nutshell, is cost-shifting. Because reverse switching PSE translates into less revenue for retailers (and consequently less taxable revenue, as well) for those consumers who choose to forego PSE-provided relief, and for those who don’t, it’s a greater healthcare cost because now consumers have to schedule an appointment with their primary care practitioner and pay the co-pay for that doctor’s visit on top of the cost of the PSE product.

Regardless of how the consumer ultimately pays for the elimination of meth labs — whether through increased taxes to cover escalating law enforcement budgets or through increased personal healthcare costs — there is another argument to be made here. Switching PSE to prescription-only status may result in fewer meth labs busted, but it’s not going to do anything about those meth addicts still on the street. Necessity is the mother of invention, and for addicts, that simply means sourcing their meth from somewhere else.

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