Pharmacotherapies for Nicotine Dependence: Social and Economic Considerations

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Author: Marian Shanahan, Chris Doran, Jennifer Stafford, James Shearer, Richard Mattick

Resource Type: Monographs

NDARC Monograph No. 54 (2004)

Tobacco smoking and alcohol consumption are the two main causes of premature and preventable death and disease in Australia. It has been estimated that in 1998, 185,557 hospital separations were attributable to tobacco and alcohol related illness; 21,084 Australians died as a consequence of tobacco and alcohol related causes; and a total of 205,726 years of life were lost as a result of this premature mortality (Ridolfo and Stevenson, 2001). Recent cost estimates suggest that the total social costs of tobacco and alcohol use are approximately $28,623 million of which around 47% are potentially avoidable (Collins and Lapsley, 2002). The Australian Government supports the use of pharmacotherapies to alleviate the burden of harm associated with tobacco smoking and alcohol misuse. This document is a report on the work examining the uptake of bupropion following its listing on the PBS.

A survey of consumers examined their use of NRTs and bupropion, and the perceptions of the effectiveness and prescribing patterns of NRTs and bupropion by practitioners were examined. While the work examining the uptake and prescribing patters of the pharmacotherapies was underway, it was realised that the public health impact on smoking cessation was minimal given the low uptake of the pharmacotherapies. Therefore it was decided to broaden the report to include a chapter on the impact of smoking in Australia, and a general chapter on the economic literature on interventions to decrease the burdens of smoking, finally an examination of the costs and outcomes of specific treatment for excessive use of alcohol in Australia. This report was prepared alongside a report on interventions to decrease the burden related to excessive alcohol use.

Each chapter of the report deals with a separate topic, and as such there are key findings for the various chapters. The final chapter of the report brings together the various findings and discusses them in a policy context.