The free cessation drugs finally are available almost five years after Congress ordered them. The free medicines are part of a wider smoking cessation program that lawmakers told the Department of Defense to establish under provisions of the fiscal 2009 defense authorization act.

The same law also directed Tricare to boost long-standing smoking cessation efforts with in-person counseling, access to print and web-based material on health effects of tobacco and a 24-hour, toll-free “quit line” with counselors to assess readiness of smokers to quit and recommend ways to address their nicotine dependency.

The smoking cessation program, including mail-order drugs, patches, gums, lozenges and sprays, is not available to beneficiaries eligible for Medicare, which means the Tricare for Life population. This is set in law to hold down costs. It also is not available outside the United States except to active duty members and families enrolled in Tricare Prime overseas.

The toll-free quit line likely will not be available overseas because of “technological barriers and costs involved in providing this service,” Tricare officials explained in a final rule published in the Federal Register Feb. 27.

Free mail-order drugs include heavily promoted medicines such as varenicline (brand name Chantix) and buproprion (Zyban) and popular nicotine replacement including patches and inhalers. All of them will require a prescription and “we can’t guarantee that every med will be available to every individual,” said a Tricare official. “That’s still a doctor’s call based on the person’s health and other medications.”

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With the Zonnic gum of its Niconovum pharmaceutical subsidiary, Reynolds is asking consumers, particularly smokers, to trust the company that got smokers hooked on nicotine to have the expertise to produce the right cessation product for them.

Until four years ago, Reynolds’ evolution into a “total tobacco company” was met with steep skepticism, if not derision, by anti-tobacco advocates.

However, the launch of Zonnic in retail outlets in Des Moines, Iowa, on Sept. 3 represents just the latest innovation for Reynolds, following up on Camel Snus and three Camel dissolvable products.

Also on tap is Reynolds’ version of an electronic cigarette (Vuse), smokeless pouches and pellets (Viceroy) and nicotine extract products such as lozenges. Vuse and Viceroy are being test-marketed in the Triad at select Tarheel Tobacco outlets.

“We hope the focus of Zonnic is on the message of the product, and not the messenger, because we believe Zonnic takes the smoker’s perspective into cessation,” said Tommy Payne, president of Niconovum USA Inc., based in Winston-Salem.

The gum represents Niconovum’s first product introduction in the United States. Reynolds bought Niconovum AB, based in Sweden, in 2009 for $44 million. Its products, which also include pouches and spray forms, are sold in Denmark and Sweden.

Payne said Zonnic already has been approved by the Food and Drug Administration.

Zonnic is the latest entrant into a nicotine-replacement therapy marketplace occupied by well-hyped products that have yielded mixed results at best in helping smokers quit.

The long-term effectiveness of NRT products was called into doubt in January by a study released by researchers at the Harvard School of Public Health and the University of Massachusetts at Boston.

The study of 787 adult smokers in Massachusetts found that the products, specifically nicotine patches and gum, “are no more effective in helping people stop smoking cigarettes in the long term than trying to quit on one’s own,” said Hillel Alpert, a research scientist with the Harvard group and the study’s lead author.

Gregory Connolly, director of the Center for Global Tobacco Control at Harvard, said the study “showed clearly that while the NRT products can help with quitting and withdrawal over two weeks to six months, they are not really designed to help with relapsing.”

Payne said that although about 70 percent of smokers annually express a desire to quit smoking, only 10 percent are successful. Of that 10 percent, about 6 percent are successful through the use of NRT products, he said.

Stop-smoking aid

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