Rise in quit attempts faded after UK smoking ban

NEW YORK (Reuters Health) - A 2007 ban on smoking inside public places across the United Kingdom may be responsible for a spike in prescriptions for medications to help smokers quit, researchers report.

But the surge in use of smoking cessation aids occurred only in the nine months before the legislation passed, and ebbed within months of the law being implemented.

The UK law went into effect July 1, 2007 and required all enclosed public spaces, including bars and workplaces, to be smoke-free.

To see whether smoking bans might influence smokers to quit, the researchers looked at 350 medical practices and the number of prescriptions doctors wrote for smoking cessation medication before and after the law was enacted.

The medications included nicotine replacement therapy, the antidepressant bupropion (Zyban), and the newest antismoking aid varenicline (sold as Chantix in the U.S.) that came onto the UK market in 2006.

In the nine months preceding the ban, prescriptions for all the medications rose by 6.4 percent, the researchers found.

Nine months after the ban, however, prescriptions dropped by 6.4 percent, they report in the journal Addiction.

"It's frankly a little bit disappointing, but not surprising," said Dr. David Abrams, the executive director of the Steven A. Schroeder National Institute for Tobacco Research and Policy Studies at the anti-smoking organization Legacy.

Abrams, who was not involved in the study, said the impending ban likely motivated people who were already poised to quit.

Once the ban is in place, "maybe you've already skimmed the cream off the top of those who were already motivated to quit," and the rate of cessation activity returns to normal, Abrams said.

"Other contextual factors and social norms continue to influence smoking behavior," said Dr. Lisa Szatkowski, a researcher at the UK Center for Tobacco Control Studies at the University of Nottingham and lead researcher on the study.

"Factors such as the provision of outdoor facilities for smoking, or spending time with smoking friends, may mean smokefree legislation does not act as a continuing stimulus to quit over time," she wrote in an email to Reuters Health.

But Szatkowski and Abrams agree that the results do not mean smoking bans are ineffective.

"The primary aim of smokefree legislation was to reduce non-smokers' exposure to environmental tobacco smoke, and the bans in the UK have undoubtedly been successful in meeting this aim. Other research confirms this," said Szatkowski, whose work was funded by the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research in the UK.

A previous report found that in the year following the UK smoking ban, hospitalizations for heart attacks dropped 2.4 percent, which the researchers attribute to the legislation (see Reuters story of June 9, 2010).

Abrams said that smoke-free legislation might be more effective at reducing smoking if smokers are given constant encouragement to quit, from media campaigns, health care providers, and local outreach efforts.

About half of states in the U.S. have some form of anti-smoking law in effect for public spaces.

SOURCE: bit.ly/k0EyUk Addiction, online May 11, 2011.