• Research Review
• Journal Review

Title: Smoking cessation medications and cigarettes in Guatemala pharmacies.

Authors: E Viteri, J Barnoya, K Hudmon, P Solorzano

Reference: Tobacco Control 2011; published online 30 June 2011
http://bit.ly/ojEE5K

Reviewer: Joaquin Barnoya, MD, MPH, Contributing Editor, ProCor; Research Assistant, Professor of Surgery, Washington University in St. Louis, Missouri, USA; Director, Research and Education, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala

Reviewer comments: Article 14 of the Framework Convention on Tobacco Control mandates signatory countries to make cessation medication affordable and accessible. As a one of the strategies to increase cessation rates, Guatemala is far from complying with Article 14. Noteworthy is the lack of generic medications and lack of advertising. To make things worse, pharmacies are also a source of cigarettes for which they do have advertising.

Purpose of study: To assess cessation medications availability and price and characterize cigarette availability and advertising in Guatemala pharmacies

Location of study: Guatemala City, Guatemala

Methods: A list of all registered pharmacies in Guatemala City was obtained from the Ministry of Health. Chain and independently owned (n=300 of each) pharmacies were randomly selected and all non-profit pharmacies (n=257) were included. In addition, all pharmacies in the nearby town of Antigua were included. A checklist previously implemented in San Francisco was translated into Spanish and adapted to Guatemala. Checklist was completed by observation and additional information was collected from the pharmacy clerk. FDA-approved first-line medications availability was recorded. Price of the least expensive cessation medication available was also collected. Product placement of both smoking cessation medications and tobacco products was also included in the checklist.

Results: A total of 505 pharmacies were included in the analysis. Smoking cessation medications were available in 22.8% of pharmacies. Chain pharmacies and Antigua pharmacies were more likely to sell medications compared to independent and Guatemala City pharmacies. Non-profit pharmacies did not stock any cessation medications. The nicotine patch, nicotine gum, varenicline and bupropion were the only smoking cessations medications available. Only 1.7% of pharmacies that sold cessation medications had any advertising for it. The median price of the least expensive medication was US$15.27. Cigarettes were found in 5.7% of pharmacies and most of them (72%) had advertising. Cessation medications were less frequently visible to the client than were cigarettes. Compared to cigarettes ($1.70), the daily cost of cessation medication was significantly higher (US$2.36).