We observed a significant decline in the use of varenicline after the passage of BBW. The BBW was not associated with decline in the use of bupropion. Passage of BBW may have a substantial impact on the utilization of certain medications. In 2009, the FDA required a black box warning (BBW) on bupropion and varenicline, the two commonly prescribed smoking cessation agents due to reports of adverse neuropsychiatric events. We investigated if there was a decline in use of bupropion and varenicline after the BBW by comparing the percent using these medications before and after BBW. We conducted a retrospective observational study using data from the Medical Expenditure Panel Survey from 2007 to 2014. The study sample consisted of adult smokers, who were advised by their physicians to quit smoking. We divided the time period into “pre-warning”, “post-warning: immediate”, and “post-warning: late.” Unadjusted analysis using chi-square tests and adjusted analyses using logistic regressions were conducted to evaluate the change in bupropion and varenicline use before and after the BBW. Secondary analyses using piecewise regression were also conducted. On an average, 49.04% of smokers were advised by their physicians to quit smoking. We observed a statistically significant decline in varenicline use from 22.1% in year 2007 to 9.23% in 2014 (p value < 0.001).
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"We have fishing areas and scenic trails that we want to keep free of cigarette litter," he said. Vaping advocates argue that e-cigarettes are not combustible, so second-hand smoke does not pose a health threat. Barber told the Times Union the ban was focused on protecting children from second-hand smoke as well as the temptation to smoke themselves. And he disagrees that e-cigarettes are harmless to the non-users who are in the vicinity of vaping. "Children watch and observe, and vaping might look like something they would want to do someday," Barber says. "And the aerosol from electronic cigarettes can contain nicotine and other carcinogens that can be inhaled by people sharing the park. E-cigarettes are just not consistent with a family-friendly park." The new law imposes a $50 fine for the first violation, while repeat offenders could find themselves paying $200-$500. "We don't need the revenue from the fines," Barber said, adding that he was confident locals would comply with the ban. The nonprofit group Capital District Tobacco Free Communities praised the ban. "Soon, all park visitors, both human and canine, will be able to breathe easier as they enjoy walking, playing, swimming, cross-country skiing, picnicking and all the other activities the town parks support," the group said in a statement. It listed some encouraging stats: Between 2000 and 2014, New York's high school youth smoking rate decreased by 73 percent to an all-time low of 7.3 percent of that population.
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