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NLMA calls on province to include tobacco cessation therapies under the NLPDP


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On November 8, the NLMA released a position paper calling on the provincial government to fund tobacco cessation medications and nicotine replacement therapies for low-income residents as a benefit under the Newfoundland and Labrador Prescription Drug Program.

By Jonathan Carpenter

On November 8, the NLMA released a position paper calling on the provincial government to fund tobacco cessation medications and nicotine replacement therapies (NRTs) for low-income residents as a benefit under the Newfoundland and Labrador Prescription Drug Program (NLPDP).

“There has not been a significant decline in the province’s smoking rate since 2003. It currently stands at about 20 per cent of the population or about 87,000 people over the age of 15. If we want to see our smoking rate decline, than we must turn our attention to helping current smokers quit,” said NLMA President Dr. Tony Gabriel.

“When smokers use NRTs and cessation medications, they increase their odds of quitting by as much as threefold… Unfortunately, access to these therapies is not universal for everyone. Low income, lack of education and other socio-economic factors are all barriers to accessing tobacco cessation aids.”

The NLMA’s Position Paper on Coverage for NRTs and Tobacco Cessation Medications recommends that the tobacco cessation medications varenicline and bupropion be covered by NLPDP and distributed through pharmacies for smokers who have a prescription from a physician. The NLMA also proposes that smokers who meet the NLPDP’s criteria should receive a free supply of NRTs for up to 12 consecutive weeks in a single calendar year.

The position paper proposes that NRTs be distributed by the Smokers’ Helpline, a toll-free confidential telephone service that anyone in the province can call and receive free support and counseling to quit smoking. Once a smoker is approved for coverage, a Smokers’ Helpline CARE Fax Referral would be automatically generated by NLPDP and sent to the Smokers’ Helpline. A counselor would then follow up with the smoker and assist them in choosing an appropriate method of NRT. They would receive the NRT either by mail or at their local pharmacy.

“The evidence clearly indicates that use of pharmacotherapy combined with counseling is the most effective approach to treating tobacco addiction and is the key to maximizing quit rates,” said Mary Lynn Pender, director of the Smokers’ Helpline.

“Every day we hear individual clients talk about the financial barriers which prevent them from availing of these very effective medications. As an established, successful service with over 10 years of experience in providing programs, consultation and leadership in smoking cessation, the Smokers’ Helpline is ideally positioned to partner on this initiative.”

Kevin Coady, executive director of the Alliance for the Control of Tobacco (ACT), explained that the call to subsidize tobacco cessation therapies was also included in ACT’s 2009-2011 Tobacco Reduction Strategy and will continue to be a key action item outlined in the soon to be released 2013-2017 strategy.

“The Newfoundland and Labrador Alliance for the Control of Tobacco is anxious to see government offer cessation help to people who meet the criteria for coverage under the province’s Prescription Drug Program,” said Coady.

“ACT believes now more than ever is the time to focus on cessation. Every possible step must be taken to help those who use tobacco find a way to beat this addiction,” he added.

The NLMA contends that the cost of subsidized tobacco cessation therapies could be funded by increasing provincial tobacco sales tax.

Dr. Gabriel explained that helping smokers quit could potentially mean huge savings for the province’s health care system, given that the cost of cessation therapies pales in comparison to the millions of dollars spent each year treating smoking-related heart disease, cancer, Type-2 diabetes and numerous respiratory illnesses.

“As long as NRTs and tobacco cessation medications are not available through NLPDP, the retail cost of these therapies will remain prohibitive to people with the lowest incomes and the highest smoking rates,” said Dr. Gabriel.

“If we want to reduce our smoking rate, lessen the economic burdens of tobacco use and prevent smoking-related illness in our province, then we must eliminate the barriers people face in accessing affordable cessation therapies.”

In addition to ACT and the Smokers’ Helpline, the position paper has been endorsed by the Association of Registered Nurses of Newfoundland and Labrador; the Newfoundland and Labrador chapter of the Canadian Cancer Society; the Newfoundland and Labrador Public Health Association; the Heart and Stroke Foundation of Newfoundland and Labrador; and the Newfoundland and Labrador Lung Association.

The Position Paper on Coverage for NRTs and Tobacco Cessation Medications (PDF) is available on the NLMA website.

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Nexus is published quarterly for Newfoundland and Labrador's physicians. It is a forum for the exchange of views, ideas and information for members.