摘要：Objectives. Recently, New York City and New York State increased cigarette excise taxes and New York City implemented a smoke-free workplace law. To assess the impact of these policies on smoking cessation in New York City, we examined over-the-counter sales of nicotine replacement therapy (NRT) products. Methods. Pharmacy sales data were collected in real time as part of nontraditional surveillance activities. We used Poisson generalized estimating equations to analyze the effect of smoking-related policies on pharmacy-specific weekly sales of nicotine patches and gum. We assessed effect modification by pharmacy location. Results. We observed increases in NRT product sales during the weeks of the cigarette tax increases and the smoke-free workplace law. Pharmacies in low-income areas generally had larger and more persistent increases in response to tax increases than those in higher-income areas. Conclusions. Real-time monitoring of existing nontraditional surveillance data, such as pharmacy sales of NRT products, can help assess the effects of public policies on cessation attempts. Cigarette tax increases and smoke-free workplace regulations were associated with increased smoking cessation attempts in New York City, particularly in low-income areas. Legislators and public health officials in New York City and New York state recently implemented a multifaceted comprehensive tobacco control program, including a state cigarette tax increase of $0.39 per pack in April 2002, a city tax increase of $1.42 in July 2002, sweeping smoke-free workplace legislation in March 2003, and a large nicotine patch giveaway program in April and May 2003. Similar policies have been shown to be effective in other jurisdictions in decreasing the prevalence of smoking, reducing tobacco use among smokers, and reducing exposure to environmental tobacco smoke. 1 – 5 Such changes are likely to result in a reduction in morbidity and mortality associated with cigarette smoking. 3 Several years may pass, however, before the public health impact of these measures can be evaluated for policymakers and the public by traditional surveillance methods such as analyses of vital statistics data or resource-intensive repeated large behavioral risk factor surveys. The emerging field of syndromic surveillance uses administrative and other routinely collected electronic data for real-time non-traditional public health surveillance. 6 , 7 The New York City Department of Health and Mental Hygiene syndromic surveillance system monitors multiple health indicators daily, including emergency department visits, 8 ambulance dispatches, 9 and pharmacy sales. 10 While this syndromic surveillance system was implemented to detect abnormal changes in these health indicators that may signal the beginning of a disease outbreak, the same data may also be used for the timely surveillance of other health outcomes, including the use of smoking cessation products. To assess the impact of smoking policies on smoking cessation in New York City, we examined temporal trends in over-the-counter pharmacy sales of nicotine replacement therapy (NRT) products, a proxy measure for cessation attempts, 11 across the city and by geographic location.
