NRT Products in demand since cigarette price hike, 06/12/10

Sales of over-the-counter nicotine replacement therapy (NRT) products appear to have increased following the government’s tax hike on tobacco products last month.

The excise duty on tobacco was increased to 25 cents per cigarette from $60 a kilo and those entering the country are no longer be allowed to bring in duty free cigarettes. The tax hike raised cigarette prices by about $5 per packet of 20 cigarettes.

Family Medicine Specialist Dr Jo Jaafar from the Jerudong Park Medical Centre (JPMC) told The Brunei Times in an interview yesterday that sales of NRTs at JPMC’s pharmacy increased nine fold last month.

“Two months prior to the tax hike, the sales of smoking cessation aids were minimal, less than two patients a month,” she said.

Dr Jo added there has also been an increase in the number of patients seeking smoking cessation guidance at the centre’s outpatient department.

Currently the medical centre stocks the Nicorette brand of nicotine gum and nicotine patches. They also stock Varenicline or Champix which is a non-nicotine smoking cessation medicine available on prescription only.

Dr Jo explained the centre will be looking at the demand for NRTs over the next few months to assess whether the current increase is temporary.

The centre is also planning to stock nicotine inhalers, which should be available by early next year. This will be sourced directly from an Australian supplier as local suppliers do not import this product. “Plans to introduce other types of smoking cessation aids will depend on the patient demand and the availability of those products from our pharmaceutical suppliers,” said Dr Jo.

The Brunei Times has only been able to locate two other sources of NRTs one of which is at the Guardian pharmacies in Centrepoint, Gadong and Giant in Rimba.

NRTs require a licensed pharmacist to dispense the product as nicotine is listed as a poison in the Poisons Act.

A spokesperson for Guardian told the paper via e-mail there have so far been no substantial increase in the sales of NRTs at the pharmacies, however, at the time of the interview (November 20) the pharmacy had run out of stock of nicotine gum and was expecting a delivery of stock within the week.

The third source for NRTs is the Ministry of Health’s (MoH) smoking cessation clinics held at the Berakas ‘A’ Health Clinic in Anggrek, Sengkurong Jubli Perak Health Centre, Seria Health Centre and Tutong Health Centre, all of which had seen increases in new registrations for their cessation programme since the tax hike.

In addition to Varenicline, the MoH clinic provides patients with nicotine patches for free. However this is only given to patients who undergo the cessation programme and have a need for nicotine replacement therapy.

Asked if there were any plans to introduce more cessation aids in the future, Acting Senior Medical Officer Dr Emina Hj Abd Rani, who is in charge of the smoking cessation clinic at the Berakas ‘A’ Health Clinic said the ministry would continue to improve their treatment plan according to the best evidence available worldwide.

She added, NRTs are expensive and nicotine patches were found to be the cheapest and easiest to use as it is discreet and can also be used during fasting.

Earlier, Dr Jo had also admitted NRTs were not cheap but it was still more cost effective to quit smoking. “Think about the morbidity you risk, losing work time, anxiety to the family and to one’s self, the cost of your quality of life in your later years. You cannot put a price on this,” said Dr Jo.

In addition to the products mentioned, NRTs are also available outside of Brunei in the form of nasal sprays, soluble tabs, oral sprays and lozenges.

An officer from the Pharmacy Enforcement Section at the MoH said these NRT products may be brought into the country for personal use without incurring tax as it is considered a medicine.

The officer added that each person can carry no more than a three month supply and customs officers may have to refer to section if they are unsure about a certain product.

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