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Prescribing of nicotine replacement therapy to cardiovascular disease patients in England


Tessa E. Langley, UK Centre for Tobacco Control Studies, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, NG5 1PB, UK. E-mail:


Aims  In November 2005 the indications for nicotine replacement therapy (NRT) were broadened in the United Kingdom, making all forms available to patients with stable cardiovascular disease (CVD). This study aimed to estimate the effects of this change on prescribing of NRT to CVD patients in England.

Design  Segmented regression analysis of time series of monthly rates of prescribing of NRT.

Setting  A total of 350 general practices in England included in The Health Improvement Network (THIN), a database of UK electronic primary care records.

Participants  All adult patients with coronary heart disease (CHD) or stroke registered with a THIN practice in England.

Measurements  The number of patients per 100 000 with CHD and stroke that received a prescription for NRT each month between January 2002 and June 2009.

Findings  Approximately 1500 per 100 000 smokers with CVD were prescribed NRT per month. Prescribing of NRT to CHD and stroke patients increased until the end of 2005 and subsequently decreased, with no immediate change following the Medicines and Healthcare Regulatory Authority (MHRA) licensing change.

Conclusions  Broadening the marketing licence in the United Kingdom for nicotine replacement therapy to allow it to be prescribed to patients with CVD did not increase prescribing rates for this group of patients.