Nicotine replacement therapy, tobacco products, and electronic cigarettes in pharmacies in St, Louis, Missouri

Objectives: To compare availability of nicotine replacement therapy (NRT), tobacco products, and electronic cigarettes (e-cigarettes) in pharmacies in St, Louis, MO. Design: Cross-sectional study, on-site store audits of 322 pharmacies. Setting: St. Louis, MO. Participants: 242 eligible community pharmacies located in the study area. Intervention: Pharmacies were visited by trained research assistants who conducted a 5- to 10-minute store audit using a paper-based data collection tool. Main outcome measures: Availability, accessibility, and pricing of NRT as a function of neighborhood poverty rate and proportion of black residents as well as availability of tobacco products and e-cigarettes. Results: NRT availability decreased as neighborhood poverty rate increased (P = 0.02). Availability without pharmacy personnel assistance also decreased with increasing poverty rate (r = -0.19; 95%ii Cl -0.06, -0.31) and higher percentage of black residents (r = -0.18; 95% Cl = -0.06, -0.31). Prices were lower in neighborhoods with higher poverty rates (P = 0.02) and a higher percentage of black residents (P = 0,03). E-cigarettes were available in 43% of pharmacies, and their availability and price did not differ by poverty rate or percentage of black residents. Conclusion: Low access to NIRT might perpetuate smoking disparities in disadvantaged and racially diverse neighborhoods. Study data support policies to ensure equal NRT access to reduce disparities.