[HealthyTribes] UPDATE: Quit Line NRT Supply Chain Issue

[HPCDP.Community]

Hello All,

I just wanted to send out an update that we just got from the Quit Line contractor.

Update:

  *   For the next few weeks, the Oregon Quit Line will be sending out 2mg NRT gum.
     *   This will be done at a 1:1 ratio, meaning that clients are not receiving double the amount of gum, but rather, the same amount in the lower dosage.
  *   The Quitline anticipates having a reliable supply of 4mg NRT gum by mid-September


Context:

  *   There is a nationwide shortage of 4mg NRT gum.
  *   The 1:1 replacement was an evidence based decision by the contractor. The exact reasoning that they chose is below:

"While we navigate supply challenges for nicotine replacement products, our primary objective continues to be supporting our members in their journey towards quitting smoking. Although there is currently a shortage of 4mg nicotine gum, replacing it with the 2mg option does not significantly impact the chances of a successful quit attempt. During the initial weeks, individuals should use the gum every 1 to 2 hours and consume at least nine pieces per day (up to a maximum of 24 pieces).

Clinical studies comparing 2mg and 4mg gums have shown no significant difference in quit rates between the two groups. More recent research indicates that only those with the highest dependence on nicotine benefit from higher-dose gums. Adherence to the prescribed regimen is a greater concern, as many individuals take lower doses than recommended or do not complete the full length of treatment.

While we generally recommend using 4mg gum when TTFU (time-to-first-cigarette) is within 30 minutes or sooner-a valid measure-there is some flexibility in defining high dependence. Certain programs adopt a broader definition that includes individuals who smoke between 20-25 cigarettes per day (or equivalent) regardless of TTFU when recommending dosage. Consequently, there are cases where members receive 2mg gum but meet the threshold for a higher dose in other circumstances.

Based on this information, there is minimal risk to members' chances of achieving successful cessation when using medication as directed. Our coaches will continue emphasizing the importance of following prescribed regimens for optimal outcomes. Additionally, [the Quitline Contractor] recommends considering combination NRT for individuals with high nicotine dependence as it offers the best chance for successful quitting."


We apologize for this change. Please reach out to Katie Reilly (KATHRYN.A.Reilly at oha.oregon.gov<mailto:KATHRYN.A.Reilly at oha.oregon.gov>) with any questions. Thank you for understanding!


Katie Reilly (She/Her)
Tobacco Prevention & Cessation Coordinator
OREGON HEALTH AUTHORITY
Public Health Division
Health Promotion and Chronic Disease Prevention
Cell: 503-798-2468
Please note my email address has changed: Kathryn.a.reilly at oha.oregon.gov<mailto:Kathryn.a.reilly at oha.oregon.gov>
http://www.oregon.gov/OHA

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