Effectiveness of free-of-charge smoking cessation medicine distribution campaigns

Objective: Sustainable reimbursement of nicotine dependence treatment increases the quit success, while free-of charge medicine distribution for a limited period increases quit attempts but not on quit success. The aim of this study is to investigate the social and health impacts of short term free-of-charge smoking cessation medicines (SCMs) distributions in Turkey. Method: Four campaigns of free-of-charge SCMs distrubution between 2011-2019 were analyzed with regard to the amount and type of medicines, percentage of population coverage, patient selection criteria, media reflections and relation with social incidences. Results: In Turkey SCMs were distributed in short-term campaings in 2011,2015,2017, 2019. During the first two campaigns Bupropion and Varenicline, during the third campaign Nicotine replacement therapy and Varenicline were distrubuted. The fourth campaign aims the distrubution of all three medicines. In every campaign 250 000 boxes were given away which will only cover 2-5 % of the population in need. The selection of patients by automated computurized system during the first two campaigns caused tension between patient and care givers. Independent studies of cessation clinics showed no increase in cessation rates. The first two campaigns were found to coincide with general parlimentary elections, third with constitutional referandum, fourth with local elections. Extensive media coverage referring to generic names of the medicines were noted. Conclusion: Free-of-charge short term distrubution of SCMs targets random smokers who do not have co morbidities and not motivated enough. Sustainable reimbursement framework will be more beneficial.