The Ministry of Social Affairs and Health set up a working group for the period 13 April 2006 to 28 February 2007 to monitor and assess the effects of the expanded sales of nicotine replacement preparations.

Since February 2006 a number of shops, kiosks and service stations that have been granted a permit have been allowed to sell nicotine preparations, in addition to the pharmacies.

In spring 2006 the process of granting permits caused a great deal of work to the local authorities and the work was piling up. By the end of the year the procedures had been established. In January 2007, nicotine preparations were sold, besides by approximately one thousand pharmacies, by 2375 shops, 355 service stations, 714 kiosks and 40 drug stores, i.e. the access to the preparations markedly expanded locally and during business hours.

In a municipality a retail-sale permit for the preparations is granted and their sales are monitored in most cases by the authority responsible for environmental health care. All the municipalities collect a charge for the permit, and for the time being 50 per cent of them collect a supervision charge. The permits have been priced on the basis of cost price and are affordable. It is relatively easy for municipal authorities to assess the conditions for granting a permit, and shops almost always fulfil those conditions. No permit applications have been rejected, and in cases where permits have been cancelled the reason has been a change of the permit holder. From the point of view of the operators the expansion of the sales of nicotine preparations has progressed well, except for the backlog at the beginning and the increased workload without additional resources, which has been criticised by the municipal authorities. It has been mainly the placement of the preparations in shops that has given rise to questions. The sale has not jeopardised drug safety, and the users seem to be satisfied.

The liberalised trade reduced the prices of nicotine preparations by on average 15 per cent as a result of the price competition and the removal of the so called pharmacy fee. Nicotine preparations are cheaper in shops than at pharmacies, kiosks and service stations, but the pharmacies have the largest assortment. There are also considerable price differences between pharmacies. The wholesale trade in nicotine packages grew by 41 per cent because of the increased number of places where they are sold, but a part of the increased sales could be accounted for filling of stores. The pharmacies’ purchases were reduced and were of the same level as in 2003 – 2004.

The working group considers that the expansion of the sales of nicotine preparations has been realised well apart from some initial difficulties. It finds the reform justified with a view to reducing tobacco smoking and proposes that:

• the sales of the preparations in shops should further be based on a permit;

• the sales of the preparations do not require more detailed provisions than the present ones and the minimum assortment of the preparations should not be regulated by law but further provisions should be issued regarding the placement of the preparations in shops;

• the National Agency for Medicines should decide on the instructions for use to be enclosed with nicotine preparations;

• further instructions should be issued for municipal authorities regarding the reporting on inspections and supervision of the places where the preparations are sold;

• the requirement that the preparations may be sold in shops only if tobacco is sold there should be eliminated;

• sale of the preparations should be allowed in restaurants; and

• the total impact of the reform concerning the sales of nicotine preparations should be assessed later as a part of the total assessment of tobacco policy in Finland.

Key words: medicines, pharmacies, tobacco, trade