An increase in primary care prescriptions of stop-smoking medication as a result of health insurance coverage in the Netherlands: population based study

Aims: To examine the impact of two national tobacco control interventions in the past decade on (dispensed) prescriptions of stop-smoking medication. Design: Ecological study with interrupted time–series analyses of quarterly data points of three nation-wide representative databases. Setting: The Netherlands 2001–2012, with the introduction of the guideline for smoking cessation care for general practitioners (GP) in 2007 and full insurance coverage for smoking cessation treatment in 2011. Participants: GPs, pharmacists and people in the general population aged 15 years and older. Measurements: Time–series plots were inspected visually and segmented regression analyses were performed to estimate the change in level and slope of (dispensed) prescriptions of stop-smoking medication and smoking prevalence in the years preceding and after the tobacco control interventions. Findings: No measurable effects of the GP guideline on (dispensed) prescriptions were observed. Shortly after the start of health insurance coverage, an estimated increase in primary care prescriptions of 6.3 per 1000 smokers [95% confidence interval (CI) = 2.9–9.8; P = 0.001] and 17.3 dispensed items per 1000 smokers (95% CI = 12.5–22.0; P