Nicotine Replacement Therapy (nicotex)

“Role of NICOTINE REPLACEMENT THERAPY (NRT) to Quit Smoking”

SUMMER INTERNSHIP (June- July) Submitted for the Partial Fulfillment of MBA (Biotechnology Management) Degree Of AMITY UNIVERSITY, UTTAR PRADESH

Julee Gogoi A0500108023

Under the Supervision of Mr. Gaurav Gupta (Business manager) Cipla Pvt. Ltd, New Delhi AMITY INSTITUTE OF BIOTECHNOLOGY AMITY UNIVERSITY, UTTAR PRADESH SECTOR 125, NOIDA- 201303, UTTAR PRADESH, INDIA 2009

ACKNOWLEDGEMENT

1

“TO THE ALMIGHTY FOR THE ASPIRATION AND INSPIRATION” It is our honors to state that we are very grateful to our institution AMITY UNIVERSITY for envisaging such a stupendous project. At the outset, I would like to place on record my gratitude to all those who have been instrumental in shaping up this project with their guidance and inspiration. I express my hearty respect and profound thanks to Mr. Gaurav Gupta for his valuable guidance in completing my project and also his sincere cooperation in directing and guiding me enabled the project to assume its systematic shape. Last but not the least I must express my gratitude to my family and various friends who gave moral support for completing this project work.

Julee Gogoi MBT/08/1027

TABLE OF CONTENTS 1.

Certificate…………………………………………….. …………1

2

2.

Acknowledgement……………………………………………. .2

3.

Table of contents………………………………………………..3

4.

Executive Summary…………………………………………….5

5.

Introduction……………………………………………………..6-31

5.1

Company profile

5.2

History

5.3

Vision

5.4

Cipla products

5.5

Cipla in the market

5.6

Swot Analysis

5.7

Strategic tie ups

5.8

Achievements

5.9

Awards

6.

Objective and Rationale of the project………………………32

7.

Literature Review……………………………………………….34-48

7.1 Introduction to the study

3

7.2 What is smoking? 7.3 Nicotine Replacement Therapy (NRT) 7.4 What is Nicotex?

8.

Research Methodology…………………………………………49

9.

Data Analysis……………………………………………………53

10. Limitations…………………………................. ………………..61

11. Conclusions……………………………………………………..62

12. Recommendations……………………………………………...64

13. References……………………………………………………….65

14. Appendix (questionnaire)……………………………………..66

4

EXECUTIVE SUMMARY The project work thoroughly looks into the adverse affects of smoking and also those who take tobacco directly. The main culprit causing such deleterious effects on the human body was thought to be nicotine. It causes diseases like lung cancer, hypertension, asthma, bladder cancer, throat cancer, stroke of central nervous system. There are about 1.2 billion smokers in the world, in which half of them are supposed to die by the diseases caused by smoking.This report aims at drawing a picture of peoples attitudes towards smoking, exposure to passive smoking and provision of cigarettes across an area. Unless stated otherwise, in this report the term ‘current smokers’ includes both occasional smokers (less than 1 cigarette a day) and regular smokers (more than 1 cigarette a day). The introduction of Nicotine Replacement Therapy (NRT), the most recent U.S. Department of Health and Human Services (DHHS) recommended NRT for first line treatment to cut down addiction has successfully led to a decrease in the mortality and morbidity and to better quality of life in tobacco smokers. NRT is available in various formulations like transdermal patch, chewing gum, nasal spray, inhaler and lozenge. Most of the studies were performed in people smoking more than 15 cigarettes a day. The limited evidence suggests that there is overall difference in effectiveness of different forms of NRT or a benefit for using patches beyond 8 weeks. NRT works with or without additional counseling, and does not need to be prescribed by a doctor. Heavier smokers may need higher doses of NRT. People who use NRT during a quit attempt are likely to further increase their chance of success by using a combination of the nicotine patch and a faster acting form. Preliminary data suggests that starting to use NRT shortly before the planned quit date may increase the chance of success. Adverse effects from using NRT are related to the type of product, and include skin irritation from patches and irritation to the inside of the mouth from gum and tablets. There is no evidence that NRT increases the risk of heart attacks.

5

INTRODUCTION The government has identified tobacco control as a key part of its approach to improving health and reducing inequalities. People need to be protected from the harmful effects of tobacco through education, legislation, cessation support and provision of smoke free environments. In order for appropriate intervention mechanisms to be developed and their effectiveness to be measured, it is essential that we obtain data on current smoking prevalence, attitudes and trends. For planners of services and interventions, this data must be developed into useful information demonstrating the various issues related to tobacco usage. This report aims at drawing a picture of peoples attitudes toward smoking, exposure to passive smoking and provision of cigarettes across an area. Unless stated otherwise, in this report the term ‘current smokers’ includes both occasional smokers (less than 1 cigarette a day) and regular smokers (more than 1 cigarette a day). Cigarette smoking is a modern epidemic. This legal addiction has its origins in childhood and once established is extremely difficult to reverse. The rate of smokers are increasing and mostly targeting the youngsters. Smoking among the adults are more than the elders due to unawareness among the youngsters and the misconception of feel good factor. This is due to the presence of nicotine in the cigarettes and gutkha. It was found that nicotine is a cause of addiction. 45% among them are females who smoke for loosing weight and to look beautiful.

COMPANY PROFILE 6

Founded Headquarters

1935 Mumbai, India

“There’ll

Key people

always be a

Industry

Pharmaceuticals

healthier way

Revenue

▲ Rs. 37.6 billion (~939M USD) (2006)

to live, a

Net income

▲ Rs. 9.1 billion (2006)

warmer way to

Employees

over 7,000

care, a surer

Website

Y. K. Hamied (CMD), Chairman

http://www.cipla.com/

way to heal, a calmer way to sleep. There’ll always be a better world, for those who have the passion to create it”. That’s been Cipla’s belief since 1935, when it began as a small Indian enterprise committed to the nation’s quest for self-sufficiency. The War that followed saw Cipla rise to the challenge of meeting the alarming shortage of essential medicines. Over the years their commitment to heal, protect and enrich lives has only grown, and so have their capabilities. Cipla, originally founded as The Chemical, Industrial & Pharmaceutical Laboratories is a prominent Indian pharmaceutical company, best-known outside its home country for producing low-cost anti-AIDS drugs for HIV-positive patients in developing countries. Cipla makes drugs to treat cardiovascular disease, arthritis, diabetes, weight control, depression and many other health conditions, and its products are distributed in more than 180 countries worldwide

HISTORY

Khwaja Abdul Hamied, the founder of Cipla, was born on October 31, 1898. The fire of nationalism was kindled in him

7

when he was 15 as he witnessed a wanton act of colonial highhandedness. The fire was to blaze within him right through his life. CIPLA IS BORN In 1935, he set up The Chemical, Industrial & Pharmaceutical Laboratories, which came to be popularly known as Cipla. He gave the company all his patent and proprietary formulas for several drugs and medicines, without charging any royalty. On August 17, 1935, Cipla was registered as a public limited company with an authorised capital of Rs 6 lakhs. The search for suitable premises ended at 289, Bellasis Road (the present corporate office) where a small bungalow with a few rooms was taken on lease for 20 years for Rs 350 a month. Cipla was officially opened on September 22, 1937 when the first products were ready for the market. The Sunday Standard wrote: "The birth of Cipla which was launched into the world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries. The first city in India can now boast of a concern, which will supersede all existing firms in the magnitude of its operations. India has lagged behind in the march of science but she is now awakening from her lethargy. The new company has mapped out an ambitious programme and with intelligent direction and skillful production bids fair to establish a great reputation in the East. "

MAHATMA GANDHI VISITS CIPLA Mahatma Gandhi visits Cipla (July 4th 1939)

8

July 4, 1939 was a red-letter day for Cipla, when the Father of the Nation, Mahatma Gandhi, honoured the factory with a visit. He was "delighted to visit this Indian enterprise", he noted later. From the time Cipla came to the aid of the nation gasping for essential medicines during the Second World War, the company has been among the leaders in the pharmaceutical industry in India.

On October 31, 1939, the books showed an alltime high loss of Rs 67,935. That was the last time the company ever recorded a deficit. In 1942, Dr Hamied's blueprint for a technical industrial research institute was accepted by the government and led to the birth of the Council of Scientific and Industrial Research (CSIR), which is today the apex research body in the country.

9

In 1944, the company bought the premises at Bombay Central and decided to put up a "first class modern pharmaceutical works and laboratory." It was also decided to acquire land and buildings at Vikhroli. With severe import restrictions hampering production, the company decided to commence manufacturing the basic chemicals required for pharmaceuticals. In 1946, Cipla's product for hypertension, Serpinoid , was exported to the American Roland Corporation, to the tune of Rs 8 lakhs. Five years later, the company entered into an agreement with a Swiss firm for manufacturing foromycene. Dr Yusuf Hamied, the founder's son, returned with a doctorate in chemistry from Cambridge and joined Cipla as an officer in charge of research and development in 1960. In 1961, the Vikhroli factory started manufacturing diosgenin. This heralded the manufacture of several steroids and hormones derived from diosgenin. The founder passes away The whole of Cipla was plunged into gloom on June 23, 1972 when Dr K A Hamied passed away. The Free Press Journal mourned the death of a "true nationalist, scientist and great soul…. The best homage we can pay to him is to contribute our best in the cause of self-reliance and the prosperity of our country in our fields of endeavour."

MILESTONES

10

1935 Dr K A Hamied sets up "The Chemical, Industrial and Pharmaceutical Laboratories Ltd." in a rented bungalow, at Bombay Central. 1941 As the Second World War cuts off drug supplies, the company starts producing fine chemicals, dedicating all its facilities for the war effort. 1952 Sets up first research division for attaining self-sufficiency in technological development. 1960 Starts operations at second plant at Vikhroli, Mumbai, producing fine chemicals with special emphasis on natural products. 1968 Cipla manufactures ampicillin for the first time in the country. 1972 Starts Agricultural Research Division at Bangalore, for scientific cultivation of medicinal plants. 1976 Cipla launches medicinal aerosols for asthma. 1980 Wins Chemexcil Award for Excellence for exports. 1982 Fourth factory begins operations at Patalganga, Maharashtra. 1984 Develops anti-cancer drugs, vinblastine and vincristine in collaboration with the National Chemical Laboratory, Pune. Wins Sir P C Ray Award for developing inhouse technology for indigenous manufacture of a number of basic drugs.

11

1985 US FDA approves Cipla's bulk drug manufacturing facilities. 1988 Cipla wins National Award for Successful Commercialisation of Publicly Funded R&D. 1991 Lauches etoposide, a breakthrough in cancer chemotherapy, in association with Indian Institute of Chemical Technology. The company pioneers the manufacture of the antiretroviral drug, zidovudine, in technological collaboration with Indian Institute of Chemical Technology, Hyderabad. 1994 Cipla's fifth factory begins commercial production at Kurkumbh, Maharashtra. 1997 Launches transparent Rotahaler, the world's first such dry powder inhaler device now patented by Cipla in India and abroad. The palliative cancer care centre set up by the Cipla Foundation, begins offering free services at Warje, near Pune. 1998 Launches lamivudine, becoming one of the few companies in the world to offer all three component drugs of retroviral combination therapy (zidovudine and stavudine already launched). 1999 Launches Nevirapine, antiretroviral drug, used to prevent the transmission of AIDS from mother to child. 2000 Cipla became the first company, outside the USA and Europe to launch CFC-free inhalers – ten years before the deadline to phase out use of CFC in medicinal products.

12

2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less than twelve months. 2003 Launches TIOVA (Tiotropium bromide), a novel inhaled, long-acting anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for patients with chronic obstructive pulmonary disease (COPD). Commissioned second phase of manufacturing operations at Goa. 2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi, Himachal Pradesh. 2007 Set-up state-of-the-art facility for manufacture of formulations at Sikkim.

CIPLA TODAY 13

Today cipla have 31 world-class manufacturing facilities spread across the country, with dedicated plants for Oncology products, Hormones, Inhalers, Carbapenems, and Cephlosporins, among others. They more than meet the stringent international standards, such as that of US FDA, MHRA–UK, TGA Australia, BFarm–Germany MCC–South Africa, WHO, TPD- Canada. Its API manufacturing plants are today among the most sophisticated in the world, capable of complex multi-stage syntheses, and produce over 120 API’s from high potency actives in grams to those made in several tonnes. Cipla produces one of the widest range of products and dosage forms in the world today, everything from metered-dose inhalers, pre-filled syringes, trans-dermal spray patches, lyophilized injections, nasal sprays, medical devices, and thermolabile foams. Whether it is constantly extending our product range or consistently introducing innovations, the mission is always to make the life of the patient better Cipla Q4 net profit up on better product-mix

Cipla is unlikely to be hit by forex-related activity, going ahead, since it has accounted for all such activity, provided there is no major rupee-related fluctuation, he said. There has been an increase of 49 per cent in other expenditure (Rs 122 crore) on account of sales expenditure, foreign exchange loss and year-end provisions

CARE BEYOND CURE 14

While there’ll be patients who are beyond cure, they should be never beyond care. The Cancer Palliative Care Centre for the terminally ill is Cipla’s labour of love for the patients and their families. A training institute for the medical community, arising from a belief that if we can’t heal their disease, we must try and heal their pain. VISION Cipla started with a vision to build a healthy India. Along the way realized, that in our own small way, we could contribute to making the world a healthier place. We’ll continue to bring a smile on as many faces as we can to heal the world as much as we can. Because there’ll always be a better world out there for those who have the passion to create CIPLA RESEARCH AND DEVELOPMENT While our skills are among the best in the world, what makes us different is our multidisciplinary approach to research. Our research capabilities are extensive, from Chemical Synthesis, Delivery Systems and Medical Devices to Process Engineering, Animal Health Products, Neutraceuticals and Biotechnology. We believe there’s no use in developing life-saving medicines if we can’t make them affordable for the patient. Today, across 170 countries, there are millions of patients who get to use a Cipla product to prevent, to cure, or for relief from suffering. In their cure and relief lies the ultimate purpose of what they do. At Cipla, this has been the driving force behind our continuous quest for quality. And quality is an obsession here for the 7000 people who walk into work every morning. World-class quality is reflected in everything we do – from start to finish. You’ll see concern for the environment in our manufacturing processes, air and water systems, safety practices, and above all, in its people. It strive not just to meet international specifications, but to exceed, to excel, to meet what we call the Cipla benchmark. In fact, it have set standards for the world to follow and have contributed to more than 125 monographs in the last 15 years - to British, European, US and international pharmacopoeia.

15

Today companies from around the world seek strategic alliances with Cipla for product development, technical support and marketing. In a small way, they even help countries set up their pharmaceutical infrastructure and train their professionals, contributing to their quest for self-reliance just the way we began healing India, seven decades ago. Over the years, they have taken on the challenges facing the world, tackling the newer dimensions of diseases, like AIDS. At a time when it was a death sentence and medication was unaffordable to most, Cipla opened the doors of hope to millions and millions of patients by becoming the first company in the world to offer the Triple-Drug AIDS Cocktail for less than a dollar a day. One out of every three HIV-AIDS patients under treatment in Africa uses a Cipla drug. Equally inspiring has been Cipla’s fight against asthma. We partnered with the medical fraternity to shatter myths, spread awareness and empowered asthma patients to lead a fuller life. We have the world’s largest range of asthma medication and delivery systems. This relentless commitment to asthma inspired us to set up the Chest Research Foundation. It’s one of the few Institutes in the world that’s dedicated to clinical and allied research in the field of Chronic Respiratory Diseases.

Technology Services Cipla offers services like consulting, commissioning, engineering, project appraisal, quality control, know-how transfer, support, and plant supply. Apart from its presence in the Indian market, Cipla also has an export market and regularly exports to more than 150 countries in regions such as North America, South American, Asia, Europe, Middle East, Australia, and Africa. For the year ended 31 March, 2007 Cipla’s exports were worth approximately Rs. 17,500 million. Cipla is also considerably well-known for its technological innovation and processes for which the company received know-how loyalties to the tune of Rs. 750 million during 2006-07. Cipla has been approved by regulatory bodies such as:

•

World Health Organization

•

Food and Drug Administration (FDA), USA

16

•

Therapeutic Goods Administration (TGA), Australia

•

Pharmaceutical Inspection Convention (PIC), Germany

•

National Institute of Pharmacy (NIP), Hungary

Cipla has recently launched i-Pill which is a single dose emergency contraceptive and has acquired a great deal of popularity in a short span of time. Other latest launches of Cipla include products such as Nova, Moxicip, Flomex, Fullform, Montair LC, and Imicrit.

CIPLA PRODUCTS

17

Cipla's products include: Prescription: •

Alzheimer’s disease- Donepezil,Rivastagmine

•

Antimalarial- Amodiaquine,Artemether 53mg

•

Cardiovascular drugs- Amlodipine,Captopril

•

Immunosuppresants- Cyclosporin,Tacrolimul

•

Anti cancer-Cisplatin,Anastrazole

•

Respiratory drugs-Albuterol sulphate

•

Antiretroviral drugs -Didanosine

Pharmaceuticals: Cipla manufactures anabolic steroids, analgesics/ antipyretics, antacids, anthelmintics, anti-arthritis, anti-inflammatory drugs, anti- TB drugs, antiallergic drugs, anticancer drugs, antifungal, antimalarials, antispasmodics, antiulcerants, immunosuppressants etc

18

Animal Health Care Products: These include: aqua products, equine products, poultry products, products for companion animals, and products for livestock animals. OTC: These include: •

Child care- Muffin &Pooch products.

•

Eye care- Occugard, Tolau care eye wash

•

Paincare- Mobix spray & ointment

•

Haircare- Beta foam mousse, Sebowash,Zinoral

•

Oral care- Chlorex mouthwash,Krystal toothwash

•

Cough,cold & flu-Cofsil cough lozenges,Nasocare

•

Skin care-Dermacil cream, Softderm cream, Benzoyl peroxide cream

NICOTEX CHEWING GUM- NICOTINE REPLACEMENT THERAPY

19

Nicotex is form of nicotine replacement therapy which help to quit smoking. It is available as nicotine polycrilex chewing gum in the strength of 2mg and 4mg. i-pill –CONTRACEPTIVE Contraceptive Pills - ipill is an emergency contraceptive pill manufactured by Cipla, to avoid unwanted pregnancy

ROTAHALER AND ASTHALIN Two drugs—Salbutamol and Theophylline, which are used in anti-asthma inhalers

20

ANTIFLU Cipla announced that Oseltamivir 75 mg capsules marketed as `Antiflu` by the company has been included in the World Health Organization (WHO) list of prequalified medicinal products (PMP). Oseltamivir is indicated for use in the treatment of influenza A (H1N1) infection commonly known as swine flu. Cipla and the Fight against HIV/AIDS in the Developing World brand-name drugs are much more expensive, so in money terms Cipla medicines are probably somewhere down the list). Roughly 40% of HIV/AIDS patients undergoing antiretroviral therapy worldwide take Cipla drugs. Ranked third in Generic market share statistics in South African Private Sector.

The customary treatment of AIDS consists of a cocktail of three drugs. Cipla produces an all-in-one pill called Triomune which contains all three substances (Lamivudine, stavudine and Nevirapine), something difficult elsewhere because the three patents are held by different

21

companies. One more popular fixed dose combination is there, with the name Duovir-N. This contains Lamivudine, Zidovudine and Nevirapine Major Indian pharma firm Cipla has notified that it has secured tentative approval from the United States Food and Drug Administration (USFDA) for its tenofovir disoproxil fumarate tablets. The drugs are prescribed for the treatment of HIV-1 infection in adults TUGAIN GEL 2/5 – Happy days are hair again Tugain gel 2/5 contains minoxidil 2% and 5% respectively with silk amino acids in a unique gel formulation. When applied, topically minoxidil stimulates hair growth in persons who are suffering from pattern baldness. Besides these advantages silk proteins also form a transparent protective film over hair, and provide a protective barrier

against

influences

of

the various

negative external

exposures. Tugain gel 2 is indicated for the treatment in men with male pattern baldness and women with female pattern baldness, whereas Tugain gel 5 is indicated for the treatment of androgenic alopecia only in men.

Bosentan for pulmonary arterial hypertension – a rare & life threatening disease

Cipla has become the first company in India to manufacture and market bosentan under the trade name BOSENTAS, a drug used to treat pulmonary arterial hypertension (PAH), a life-threatening condition.

22

BOSENTAS (bosentan) is an orally active dual endothelin receptor antagonist (ERA). Bosentan works by blocking the binding of endothelin (ET). ET is produced and secreted by the endothelium, a monolayer of cells covering the inner surface of blood vessels Autohaler: Just breathe in........ The Autohaler

TM

is the first breath

actuated or activated pressurized metered dose inhaler (BAI). This overcomes the key problem of the pressurized metered dose inhaler (pMDI)

viz.

coordination

of

actuation with inhalation and does not rely on the patient's inspiratory effort to aerosolize the dose of medication unlike dry powder inhalers . It is activated at low flow rates of 22-30 l/sec Vesigard: Selective Effective Distinctive Overactive bladder is a symptom-defined condition characterized by urinary urgency, with or without urgency incontinence, usually with urinary frequency and nocturia.

Vesigard

extended-release

tablets are indicated for the treatment of overactive bladder with symptoms of urge urinary

incontinence,

urgency

and

frequency. NICOCHEW – The N revolution NICOCHEW 2mg and 4mg sugar free chewing gum A nicotine replacement therapy (NRT) to cut down addiction towards smoking. It provides small and sustained quantities of nicotine without the harmful gases of smoking,

23

to reduce the severity of withdrawal symptoms and cravings. By stopping as early as possible, there can be a reduction in the risk of cancer, lung and heart disease. There is also a reduction in the damage caused to the lungs. Nicochew chewing gum is indicated for smoking cessation therapy MTP kit: A Simple and Convenient Option MTP Kit is indicated for the medical termination of intrauterine pregnancy up to 63 days of gestation. The regimen has also been recommended by WHO and RCOG MTP kit contains 1 tablet of mifepristone 200 mg to be given orally and 4 tablets of 200 mcg misoprostol to be given vaginally

Combace: i-friendly, Ace Combination Moxifloxacin 0.5% + Prednisolone acetate 1% Combace: Worlds First Preservative Free Ace Combination Ocular inflammation and infection often coexist and the clinician is always in search of a medication, which offers efficacy, tolerance and convenience. Combination of antibiotic-steroid exerts efficacy in resolving both infection and inflammation. Steroids are to be used preserve normal structure of involved tissues while antibiotic component reduces risk of infection. Thus a combination of corticosteroid and antibacterial strikes a favorable balance. Combace is a fixed dose combination of gold standard steroid (Prednisolone acetate l) and ace bactericidal (Moxifloxacin), which is preservative free. Retilone: Trust the known Corticosteroids have been used to treat inflammatory conditions of the eye since the 1950s and have been injected intraocularly since 1974.

24

CLACENT: Results - Sure Shot The drug is active against Haemophilus influenzae, Moraxella catarrhalis , penicillin susceptible Streptococcus pneumoniae, Streptococcus pyogenes and many Enterobacteriaceae. The available oral formulations also provide convenient outpatient or step-down therapy against susceptible pathogens. CLACENT

is

Respiratory ENT

indicated

tract

Infections

infections

–

Chronic

for –

the

Bronchitis,

Maxillary

treatment

Bronchiectasis,

Sinusitis,

Chronic

of: Pneumonia

Otitis

Media

Urinary tract infections – Acute uncomplicated and complicated urinary tract infection’

PHOSOME: Designed to Deliver Now Cipla has created a “Magic Bullet” in Phosome for treatment like •

Empirical therapy for presumed fungal infection in febrile,

neutropenic patients.

25

•

Treatment of Cryptococcal Meningitis in HIV infected

patients. •

Treatment of patients with Aspergillus species, Candida

species and/or Cryptococcus species infections refractory to or with renal impairment or toxicity to AMB •

Treatment of visceral leishmaniasis.

KETODROPS LS: Heal with Comfort KETODROPS LS ophthalmic solution is indicated for the reduction of ocular pain and burning/stinging following corneal refractive surgery

URISODA - To Raise N Alkalize URISODA is a urinary alkalizer. It is used to provide symptomatic relief of dysuria. chronic metabolic acidosis, an antacid to neutralize gastric acid, conjunction with uricosuric agents in the treatment of gout to prevent uric acid nephropathy. It is also useful in conditions where long term maintenance of alkaline urine is desirable, and in the prevention and treatment of uric acid and cystine kidney stones INFLUVAC- Power to Protect

26

INFLUVAC is an inactivated subunit vaccine for influenza. It contains surface antigens (Haemagglutinin and Neuraminidase) for 3 subtypes of influenza virus. This vaccine complies with the World Health Organization (WHO) recommendation (northern hemisphere) and the competent authority decision for the applicable season. Flavour & Fragrance: Cipla manufactures a wide range of flavours, which are used in foods and beverages, fruit juices, baked goods, and oral hygiene products. Cipla fragrances have wide ranging applications such as in personal care products, laundry detergents and room fresheners. AGROCHEMICALS: this includes manufacturing of agricultural products •

Fungicide-Chlorothalonil

•

Herbicide- Atrazine,2,4 D amine

•

Insecticide- Acephate, Abamectin

•

Organic products-Neem cake, Organic plant products

•

Plant growth regulator-GA3,Naphthyl acetic acid

BULK DRUGS  Active Pharmaceutical Ingredients  Antibiotics  Anti cancer drugs  Anti malarial drugs  Cardiovascular drugs  CNS drugs  Drug intermediates CIPLA IN THE MARKET

27

Cipla vs. S&P Nifty (1 Year) -

Cipla has followed the market trend for the last 1 year; and

-

In December 2008, Cipla somewhere breached the market line crossing it to end at approx Rs. 600.

 What’s in it for the investor? -

HOLD on to your stock to benefit from its “Capital Appreciation”;

-

The “Estimations” showcase the company to be a healthy company with positive and healthy FCFF;

-

As of 9 December 2008 Cipla stands at Rs. 247. The price is Rs. 292

SWOT ANALYSIS

28

STRENGTHS -

Ranks #2 in the retail prescription market in India;

-

18 brands that feature among the top-300 brands;

-

Large basket of 1,500 formulations; and

-

Partnered 8 leading generics companies in the US for nearly 125 projects.

WEAKNESSES -

Impact of IPR regime.

OPPORTUNITIES -

Biotherapeutics – A new and promising area;

-

Agreement with Avesthagen; and

-

Venturing towards areas of cardiology and anti-cancer.

THREATS -

Partnership related; and

-

Potential de-rating

STRATEGIC TIE-UPS

29

 Subsidiary in Dubai: Cipla has set up a wholly owned subsidiary, Cipla FZE situated at Jebel Ai Free Zone in Dubai, United Arab Emirates. This is the part of strategy to explore the growing markets in middle east countries through exports.  It has a research alliance with a Bangalore-based biotech company Avesthagen, to develop biotherapeutic products;  Cipla entered agreement with Pentech Pharma of USA for marketing a range of generic products for American market;  The first phase of the new formulation plant at Baddi, Himachal Pradesh, for the manufacture of tablets and capsules commenced commercial production in April 2005; and  Presence in Africa and Europe. CIPLA’S FINANCIAL REPORT

30

GLOBAL PRESENCE

Cipla's manufacturing facilities have been approved by: FDA, USA; MHRA, UK; TGA, Australia; WHO etc

31

MAJOR ACHIEVEMENTS OF CIPLA •

Manufactured AMPICILLIN for the first time in India

•

Cipla launches medicinal AEROSOLS for asthma.

• Develops anti-cancer drugs, VINBLASTINE AND VINCRISTINE in collaboration with the National Chemical Laboratory, Pune •

Lauches ETOPOSIDE, a breakthrough in cancer chemotherapy.

• Launches transparent ROTAHALER, the world's first such dry powder inhaler device now patented by Cipla in India and abroad. • Launches NEVIRAPINE, antiretroviral drug, used to prevent the transmission of AIDS from mother to child. • Cipla became the first company, outside the USA and Europe to launch CFC-free inhalers • Launches TIOVA (Tiotropium bromide), a novel inhaled, long-acting anticholinergic bronchodilator AWARDS •

The Scrip Best Company in an Emerging Market Award.

• The Dun & Bradstreet - American Express Corporate Award for the best company in the pharmaceutical sector. •

The Pharma Excellence Award for Sustained Growth.

OBJECTIVE AND RATIONALE OF THE PROJECT 32

AIM TO STUDY THE ROLE OF NICOTINE REPLACEMENT THERAPY (NRT) TO QUIT SMOKING

BACKGROUND The aim of nicotine replacement therapy (NRT) is temporarily to replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. OBJECTIVES•

To Understanding of health risks and bio psychosocial factors in smoking

•

To study the dangers of smoking to health and reasons to quit them

•

To study the maximum number of age groups who smoke

•

To receive a comprehensive analysis of the prospects for smoking cessation

therapies •

To discover the use of Nicotex chewing gum(NRT) among the smokers who want

to quit. •

To identify key pipeline developments and up-and-coming products.

•

To discover the forces, restraints, competition and opportunities influencing each of

the separate areas of the smoking cessation market, including nicotine replacement therapies and bupropion drugs. •

To find out where the market is heading - both technologically and commercially

from the present onwards. •

To explore whether NRT- NICOTEX has been used in the market or not.

•

To determine whether NICOTEX is more or less likely to lead to successful quitting

compared to other pharmacotherapies.

To

33

SCOPE OF THE STUDY

•

To attempts to stop smoking which help company in formulating suitable strategies

to promote Nicotex Chewing Gum •

Also the best attitudes and preferences of the smokers

•

Focus on pharmaceuticals to promote the product as well as the brand

•

Also attempts to make proper use of the NRT to the patients as they will not get any

side effects

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LITERATURE REVIEW Market research

Market research is the process of systematically gathering, recording and analyzing data and information about customers, competitors and the market. Its uses include to help create a business plan, launch a new product or service, fine tune existing products and services, and expand into new markets. Market research can be used to determine which portion of the population will purchase a product/service, based on variables like age, gender, location and income level. Market research is generally either primary or secondary. In secondary research, the company uses information compiled from other sources that appears applicable to a new or existing product. The advantages of secondary research are that it is relatively cheap and easily accessible. Disadvantages of secondary research are that it is often not specific to your area of research and the data used can be biased and is difficult to validate. Primary market research involves testing such as focus groups, surveys, field tests, interviews or observation, conducted or tailored specifically to that product. A list of questions that can be answered through market research: •

What is happening in the market? What are the trends? Who are the competitors?

•

How do consumers talk about the products in the market?

•

Which needs are important? Are the needs being met by current products?

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INTRODUCTION TO THE STUDY Smoking harms nearly every organ in the body, causes many diseases, and compromises smokers´ health in general. Nicotine, a component of tobacco, is the primary reason that tobacco is addictive, although cigarette smoke contains many other dangerous chemicals, including tar, carbon monoxide, acetaldehyde, nitrosamines, and more. The government has identified tobacco control as a key part of its approach to improving health and reducing inequalities. People need to be protected from the harmful effects of tobacco through education, legislation, cessation support and provision of smoke free environments. In order for appropriate intervention mechanisms to be developed and their effectiveness to be measured, it is essential that we obtain data on current smoking prevalence, attitudes and trends. For planners of services and interventions, this data must be developed into useful information demonstrating the various issues related to tobacco usage. This report aims at drawing a picture of peoples attitudes toward smoking, exposure to passive smoking and provision of cigarettes across an area. Unless stated otherwise, in this report the term ‘current smokers’ includes both occasional smokers (less than 1 cigarette a day) and regular smokers (more than 1 cigarette a day).

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Comparative cause of annual deaths WHAT IS SMOKING? Smoking refers to the inhalation and exhalation of fumes from burning tobacco in cigars, cigarettes and pipes. Tobacco smoke contains nicotine - a poisonous alkaloid - and other harmful substances like carbon monoxide

With every puff, you are breathing in all of these... Hydrogen Cyanide - Gas Chamber Poison This gas was used in Nazi Germany gas chambers. As part of their genocide program, it was designed for quick mass killing. Arsenic - Rat Poison This potent and discreet poison was used by the ruling class to murder one another. Arsenic is deadly. It’s been called the Poison of Kings and the King of Poisons. Tar - Sticky Black Substance Tar is directly linked to lung cancer. Once inhaled, about 70 per cent of the tar within the smoke is deposited in your lungs. It also rots and blackens teeth and causes gum disease. Benzene - Petrol Additive This colorless chemical obtained from coal and petroleum. It is well known carcinogen associated with leukemia. Formaldehyde - Embalming Fluid Used to preserve dead bodies, this colorless, highly poisonous liquid is known to cause cancer, and respiratory, skin and gastrointestinal problems.

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Ammonia - Toilet Cleaner By adding ammonia to your cigarettes, nicotine can be absorbed through your lungs more quickly. Two teaspoons of ammonia is deadly. Carbon Monoxide - Car Exhaust Fumes Known as a silent killer, this poisonous gas can be quickly fatal in large amounts. It's the same gas that comes out of car exhausts and is the main gas in cigarette smoke. CHEMISTRY OF TOBACCO SMOKE

It is not Nicotine but the other compounds in tobacco smoke that cause trhe harmful effects of the body. Tar is the store house of many carcinogens that are responsible for the deleterious effects cause on human body, contrary to the belief that nicotine causes the harmful effects like cancer.

WHAT IS NICOTINE? Nicotine, a component of tobacco, is the primary reason that tobacco is addictive. NEUROBIOLOGY OF NICOTINE

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•

Evidence that nicotine is addictive

Most of the toxicity of smoking is related to other components of the tobacco smoke, the pharmacological effects of nicotine produce the addiction to tobacco. There are many lines of evidence for tobacco addiction and the role of nicotine in sustaining tobacco addiction. The basic line of evidence is that most smokers state they would like to quit smoking but are unable to do so easily. Nicotine also meets the Surgeon General’s primary criteria for drug addiction, which state that the drug must: 1. promote compulsive use 2. have psychoactive effects 3. reinforce its own use •

Understanding the addiction

When a cigarette is smoked, nicotine rich blood passes from lungs to the brain within 7 seconds and immediately stimulates the release of many chemical messengers. Nicotine receptor activation promotes the release of neurotransmitters, which may then mediate various effects of nicotine use.

This release is mediated through the activation of nicotinic acetocholine receptors (nAchRs). The alpha4beta2 receptor subtype is predominant in the human brain and is believed to be the main receptor mediating nicotine dependence.

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NICOTINE REACHES BRAIN

SMOKING

ANOTHER CIGRETTE

DOPAMINE RELEASE

CRAVING FOR MORE

CALM AND PLEASANT FEELING

FEEL GOOD FACTOR DISAPPEARS

•

NICOTINE LEVEL FALLS

Withdrawl effects

Craving and withdrawal symptoms begin in chronic smokers when previously desensitized nAchRs become unoccupied and recover to a responsive state during periods of abstinence. These include irritability, depressed mood, restlessness, anxiety, problems getting along with friends and family, difficulty concentrating, increased hunger and eating, insomnia and craving for tobacco. •

Conditioning Conditioning is a major factor that causes relapse to drug use after a period of cessation

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HARMFUL EFFECTS OF SMOKING •

Tobacco smoke contributes to a number of cancers.

•

High blood pressure

•

The mixture of nicotine and carbon monoxide in each cigarette you smoke

temporarily increases your heart rate and blood pressure, straining your heart and blood vessels. •

This can cause heart attacks and stroke. It slows your blood flow, cutting off

oxygen to your feet and hands. Some smokers end up having their limbs amputated. •

Tar coats your lungs like soot in a chimney and causes cancer. A 20-a-day smoker

breathes in up to a full cup (210 g) of tar in a year. •

Changing to low-tar cigarettes does not help because smokers usually take deeper

puffs and hold the smoke in for longer, dragging the tar deeper into their lungs. •

Carbon monoxide robs your muscles, brain and body tissue of oxygen, making your

whole body and especially your heart work harder. Over time, your airways swell up and let less air into your lungs. •

Smoking causes disease and is a slow way to die. The strain of smoking effects on

the body often causes years of suffering. Emphysema is an illness that slowly rots your lungs. People with emphysema often get bronchitis again and again, and suffer lung and heart failure. -Effects the alveoli .The smokers cough weekens the walls of the alveoli, therefore the lungs can not take in enough oxygen which leads to breathlessness. •

Lung cancer from smoking is caused by the tar in tobacco smoke. Men who smoke

are ten times more likely to die from lung cancer than non-smokers. •

Smoking

Affects

those

Associated

with

Smokers too Health groups are increasingly targeting smokers who inhale tobacco smoke for increasing the risk of heart disease and respiratory problems for them. These have resulted in dedicated movements

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for smokeless environments in public spaces such as government buildings, office buildings and restaurants. HEALTHY LUNG You can see how the lung looks without the effects of inhalation of smoke. Note black specks throughout indicative of carbon deposits from pollution

LUNG AFTER SMOKING Smokers lung with cancer. White area on top is the cancer, this is what killed the person. The blackened area is just the deposit of tars that all smokers paint into their lungs with every puff they take •

Heart disease and strokes are also more common among smokers than non-smokers.

•

Smoking causes fat deposits to narrow and block blood vessels which lead to heart

attack. •

Smoking causes around one in five deaths from heart disease.

•

In younger people, three out of four deaths from heart disease are due to smoking.

•

Cigarette smoking during pregnancy increases the risk of low birth weight,

prematurity, spontaneous abortion, and perinatal mortality in humans, which has been referred to as the fetal tobacco syndrome.

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Benefits of Quitting Smoking When smokers quit, within twenty minutes of smoking that last cigarette the body begins a series of changes.

HOW TO QUIT SMOKING?

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Quitting smoking is a two-step process that includes: 1- breaking the smoking habit 2- overcoming the physical addiction to nicotine The basic idea is to allow the smoker to break the cigarette habit before attempting to actually get off the nicotine. This separates some of the difficulty of quitting from the physical withdrawal and lets you do it in two stages. Later the dosage is lowered and the smoker is slowly weaned off the nicotine replacement.

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NICOTINE REPLACEMENT THERAPY (NRT) NRT is a way of getting nicotine into the bloodstream without smoking. Nicotine replacement therapy (NRT) is the use of various forms of nicotine delivery methods intended to replace nicotine obtained from smoking or other tobacco usage. These products are intended for use in smoking cessation efforts to help deal with withdrawal symptoms and cravings caused by the loss of nicotine from cigarettes. Several forms of NRT have been marketed, including the nicotine patch, inhaler, nasal spray, gum, sublingual tablet, and lozenge Vereniciline and Bupropion SR, tablets—Available by prescription NRT is thought to be useful and beneficial for tobacco users who want to quit their addiction and is for most people perfectly safe. Cigarettes can be viewed as a "dirty" and dangerous method of delivering nicotine, while NRT is a "clean" and safe method.

How does NRT work? Mechanism of action NRT acts in two ways

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1)The principle mechanism of action of NRT is to partially replace the nicotine formally obtained from tobacco. It provides small and sustained quantity of nicotine without the harmful gases of smoking, to reduce the severity of withdrawal symptoms and cravings. Ameriolation of withdrawal symptoms is observed with relatively low blood levels of nicotine which also provides for some reinforcing and cognitive effects. 2)A second possible mechanism of benefit is the potential to desensitize nAchRs. Such desensitization would result in reduced effect of nicotine from cigarettes, in case a person relapses to smoking while taking NRT. Hence, NRT provide a coping mechanism, making cigarettes less rewarding to smoke.

WHAT IS NICOTEX? Nicotex is form of nicotine replacement therapy which help to quit smoking. It is available as nicotine polycrilex chewing gum in the strength of 2mg and 4mg. DOSAGE FORM Chewing gum

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HOW TO USE NICOTEX? If smoking 25 or more cigarettes a day, use 4mg nicotine gum If smoking less than 25 cigarettes a day, use 2mg nicotine gum Use according to the 12 week schedule: Weeks 1-6 Weeks 7-9 Weeks 10-12 1 piece of gum every 1-2 1 piece of gum every 2- 1 piece of gum every 4-8 hours 4hours hours Do not consume more than 24 pieces of gum a day. Steps to follow for maximum benefit: 1. Chew each gum piece very slowly several times. 2. Stop chewing when you get a peppery taste or a slight tingling in the mouth. This usually happens after about 1 minute or 15 chews, but may vary from person to person. 3. Shift the chewing gum to one corner or side of your mouth, and leave it there.

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4. When the peppery taste or tingle is almost gone (in about a minute), again start chewing the gum piece slowly. Stop when the taste or tingle returns. 5. Shift the gum to a different place in your mouth every time. 6. Repeat steps 4 to 7 until most of the nicotine is gone from the NICOTEX Chewing Gum (usually happens in about 30 mins; the peppery taste or tingle will not return). 7. Wrap the used gum in paper and throw it away in the dustbin. 8. To improve the chances of quitting, use at least nine pieces of NICOTEX Chewing Gum a day. If strong or frequent cravings are experienced, a second piece can be used within the hour. However, continuous use of one gum piece after another is not recommended, since this may cause hiccups, heartburn, nausea, or other side effects. 9. It is important to complete the NICOTEX quit programme at the end of 12 weeks, and to stop using NICOTEX Chewing Gum at that time. CONTRAINDICATIONS NICOTEX Chewing Gum is contraindicated in patients with a hypersensitivity to nicotine polacrilex or any other components of the chewing gum SHELF-LIFE 2 years STORAGE Store at 20–25°C (68–77°F) Protect from light PACKAGING INFORMATION NICOTEX Chewing Gum Pack of 10 gum pieces WARNINGS AND PRECAUTIONS Do not use in the following conditions: •

If patients continue to smoke, chew tobacco, use snuff, or use a nicotine patch or other nicotine-containing products.

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•

In the presence of unstable heart disease, recent myocardial infarction, or irregular heartbeat. Nicotine can increase the heart rate.

•

In case of high blood pressure not controlled with medication. Nicotine can increase blood pressure.

•

Stomach ulcer or diabetes

•

Using a non-nicotine stop-smoking drug.

•

Taking prescription medicine for depression or asthma. The prescription dose may need to be adjusted.

Stop if: •

Mouth, teeth or jaw problems occur.

•

Irregular heartbeat or palpitations occur.

•

Symptoms of nicotine overdose such as nausea, vomiting, dizziness, diarrhoea, weakness, and rapid heartbeat occur.

PHARMACOLOGY Pharmacodynamics The principal mechanism of action of nicotine replacement therapy (NRT) is to partially replace the nicotine formally obtained from tobacco. It provides small and sustained quantities of nicotine without the harmful gases of smoking, to reduce the severity of withdrawal symptoms and cravings. Amelioration of withdrawal symptoms is observed with relatively low blood levels of nicotine, which also provides for an alternative source of some reinforcing and cognitive effects. A second possible mechanism of benefit has been suggested to be the potential for nicotine medications to desensitize the nicotinic acetylcholine receptors (nAchRs). Such desensitization would result in a reduced effect of nicotine from cigarettes, such that if a person relapses to smoking while taking NRT, the cigarette would be less satisfying and the person less likely to resume. Hence, NRT also provide a coping mechanism, making cigarettes less rewarding to smoke. Pharmacokinetics Absorption: 49

Nicotine is a weak base with a p K a of 8.0. In its ionized state, such as in acidic environments, nicotine does not rapidly cross membranes. Nicotine from the chewing gum is released slowly and depends on the intensity of chewing. This nicotine is buffered to alkaline pH in the oral mucosa to facilitate absorption. Concentrations of nicotine in the blood rise gradually and plateau at about 30 minutes, with levels persisting and declining slowly over the next 2 hours. This slow increase in blood and, especially, brain levels results in low abuse liability of the gum. The absolute dose of nicotine absorbed systemically from nicotine gum is much less than the nicotine content of the gum, because some amount of nicotine is swallowed with subsequent first-pass metabolism. Nicotine is poorly absorbed from the stomach because it is ionized in the acidic gastric fluid. The bioavailability of nicotine from the gum ranges between 55–78%.

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RESEARCH METHODOLOGY RESEARCH DESIGN The following research is Descriptive Research which is based on facts and figures. This project is done according to the “descriptive research design.” A research design is a framework or a blue print for conducting the market research project. It details the procedures necessary for obtaining the information needed for obtaining the information needed to structure or solve a marketing research problem. Design maybe broadly classified into: - Exploratory research - Conclusive research Conclusive research is typically more formal and structured than exploratory research. It is based on large representative samples and that data obtained are subjected to a quantitative analysis. The findings from this research are considered to be conclusive in nature in that they are used as input into marginal decision making. As the name implies, major objective of “descriptive research” is to describe something usually market characteristics and time. Descriptive research is pre planned and structured. It is typically performed on large representative samples. A descriptive design requires a clear specification of the “who, what, when, where, why and way (the W’s of research). Descriptive research assumes that the research has much prior knowledge about the problem solution.

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SAMPLING DESIGN Rarely will be a marketing research project involves examining the entire population i.e. relevant to the problem,In considering the sampling design there are three things-

 Who is to be surveyed (Sampling Unit)?  How many people are to be surveyed (Sample Size)?  How should the people on the sample be chosen (Sampling Procedure)? 1.Patients surveySample size The total sample size was 200. Research period Research was conducted in the month of June. 2. Retailers survey Sample size The total sample size was 200. Research period Research was conducted in the month of July.

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DATA COLLECTION METHOD Data was selected from the New Delhi region database for the period of 5 th june to 20th june for Patients Survey and 27th june to 20th july for Retailers Survey. For Patients Survey I fill the questionnaires of 10-15 smokers having 8 questions per day. For Retailers Survey I fill the questionnaires of 8-10 retailers having 6 questions per day. Data Collection Mainly Primary data was used in my research and a bit of secondary data for understanding the background of my research. Methods of Data Collection:  Primary Data: Two types of primary data, i.e. Questionnaire method and Interview method was used in the survey. Primary data are generally information gathered or generated by the researcher for the purpose of the project immediately at hand. The data for the analysis was collected through direct interview of the prospects’. This method Involves asking prospects and extracting the proper information in terms of written responses. I visited 5-6 customers a day, and few of them filled the questionnaires also.

Secondary Data: Data, documents, records, or specimens that have been collected, are in existence prior to the beginning of the study. It had information about our product and its terms and also details about the other competitor companies of our product existing in the same market. This information was extracted from facts and figures already there, from magazines, internet, journals etc.

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QUESTIONNAIRE Having defined the sample size and the type of data to be collected, the next step is to develop the questionnaire and deciding on what all elements will be included in it. The design of the questionnaire can have as much influence over the response rate as the method of completion. The questionnaire prepared for the patients survey comprised of 8 questions and 6 questions for retailers survey. The questionnaire included both open as well as close ended questions. DATA ANALYSIS The data were initially analyzed in the excel sheet with the help of Microsoft Office Excel 2003. The results were then presented in the form of different types of charts; column charts, bar charts & pie charts.

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DATA ANALYSIS OF THE PROJECT IN NEW DELHI (PATIENTS SURVEY) Age group of respondent

AGE GROUP OF RESPONDENTS 80 70 60 50 NO. OF 40 SMOKERS 30

SMOKERS

20 10 0

15-20

20-25

25-30

30-35

35-40

40+

AGE GROUPS

Peoples of age groups between 25-30yrs smoke more as compared to other age groups 1. When asked how soon they smoke their first cigarette

FIRST CIGRATTE PER MINUTE 120 100 80 NO. OF SMOKERS

60 SMOKERS

40 20 0

5

6-30

31-60

60+

TIME (IN MIN)

Smokers like to smoke every 60min after their first cigarette, where frequent smokers are very less in no. who would like to smoke every 5 min.

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2. When asked do they find it difficult to refrain from smoking in public places

FIND DIFFICULT IN PUBLIC PLACES

42% YES NO 58%

The no. of smokers who find difficult to smoke in public places is not very high. About 42% said ‘yes’ and 58% said ‘no’.

3. When asked which cigarette they hate most to give up

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CIGARETTE DIFFICULT TO GIVE UP

10% 1ST ONE IN THE MORNING ANY OTHER 90%

About 90% smokers find it difficult to give up their 1st cigarette

4. cigarettes per day they smoke

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CIGARETTES PER DAY 160 140 120 100 NO. OF 80 SMOKERS 60 40 20 0

>10

11-20

21-30

30+

NO. OF CIGARETTES

People who smoke less than 10 cigarettes per day is maximum, whereas 30+ cigarettes per day smokers is nil

5. frequent smoking during the first hours after awakening

SMOKING DURING THE FIRST HOURS

7% YES NO

93%

About 93% smokers said yes who would like to smoke during the first hour. This means most the smokers are addicted to regular dosage of nicotine

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6. when asked do they smoke when they are ill

SMOKING DURING ILLNESS

28%

YES NO

72%

Most of the smokers still want to smoke even when they are ill.

7. How long they are smoking

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HOW LONG THEY ARE SMOKING 140 120 100 NO. OF SMOKERS

80 60 40 20 0

TIME(IN YEARS)

>1

>5

>10

>15

TIME(IN YEARS)

People who smoke from less than 5 years seems to be maximum as compared to other

8. Do they want to quit smoking

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DO THEY WANT TO QUIT

46% YES NO 54%

The numbers of respondents who doesn’t want to quit smoking is more as compared to the respondents who want to quit.

RETAILERS SURVEY 1. Do they smoke

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RESPONDENTS WHO SMOKE

12%

YES NO

88%

Most of the retailers are non smokers.

2. highest selling brand for Nicotine Replacement Therapy (NRT)

HIGHEST SELLING BRAND FOR NICOTINE REPLACEMENT THERAPY NICOGUM 19% CHEMPIX 3% NULIFE 9%

NICOTEX 69%

NICOTEX NULIFE CHEMPIX NICOGUM

NICOTEX (69%) is the highest selling and most preference brand whereas very few buy NICOGUM(19%) and CHEMPIX and NULIFE loose preference

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3. when asked whether patients come directly and ask for any medicine

DO PATIENTS COME DIRECTLY TO BUY NRT NO 2% YES NO

YES 98% Maximum patients come directly to buy nicotine replacement therapy

4. patients buy medicine (NRT) regularly

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NO. OF PATIENTS BUY NRT REGULARLY 200 150 100 50 0

>5

>10

>15

>20

NO. OF PATIENTS

The no. of patients are very less who buy NRT regularly. There are less than 5 or 10 peoples who come to buy NRT

5. To get associated in efforts of making quit smoking

DO THEY WANT TO GET ASSOCIATED NO 12% YES NO

YES 88%

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Most of the chemists want to get associated in efforts of making quit smoking

LIMITATIONS Though every effort was put in to make this report authentic in every respect, there were few uncontrollable factors that might have had their influence on the final report. The various limiting factors are-:  While making this report few typing and compilation result may have crept in which have not been able to get rectified.

Also the major part of the data

collect is primary in nature and hence the data may be subject to some human errors.  Since the basic objective of the project is to find out the role of Nicotine Replacement Therapy NRT to quit smoking. The smokers and retailers perception and compare it with that of the project standards, it involved 65

collection of the information that is confidential from the point of view of interviewee.

Thus some individuals were tentative in giving such kind of

information. This has rendered minor impact on the conclusion of the report.  The study was mainly conducted in the national capital region of Delhi. It has not have included relevant respondents in other areas in the sample size.  Most of the Questionnaire are poorly filled.  Some of the options are left out  Some of the respondent just tick marked all ranking questions.  Some of the respondents gave same ranks to all the ranking questions.  Some of the respondents are not willing to fill the questionnaire so they just filled it without knowing the answers.

CONCLUSION Smoking prevalence is increasing overall, with increases mainly contributed by developing countries. Adverse health effects and the high economic costs associated with tobacco smoking are encouraging increasingly-stringent smoking legislation and encouraging governmental spending on anti-smoking aids. All of the commercially available forms of NRT (gum, transdermal patch, nasal spray, inhaler and sublingual tablets/lozenges) can help people who make a quit attempt to increase their chances of successfully stopping smoking. NRTs increase the rate of quitting by 5070%, regardless of setting. Peoples of age groups between 25-30yrs smoke more as compared to other age groups. Smokers like to smoke every 60min after their first cigarette,

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where frequent smokers are very less in no. who would like to smoke every 5 min. Most of the smokers still want to smoke even when they are ill.

The no. of smokers who find difficult to smoke in public places is not very high. About 90% smokers find it difficult to give up their 1st cigarette. People who smoke less than 10 cigarettes per day is maximum. About 93% smokers said yes who would like to smoke during the first hour. This means most of the smokers are addicted to regular dosage of nicotine.People who smoke from less than 5 years seems to be maximum as compared to other.The numbers of smokers who doesn’t want to quit smoking is maximum as compared to the one who want to quit.Most of the retailers are found to be non smokers. NICOTEX (69%) is the highest selling and most preference brand whereas very few buy NICOGUM(19%) and CHEMPIX and NULIFE loose preference.Maximum patients come directly to buy nicotine replacement therapy.

The no. of patients are very less who buy NRT regularly. There are less than 5 or 10 peoples who come to buy NRT.Most of the chemists want to get associated in efforts of making quit smoking The effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the individual. The provision of more intense levels of support, although beneficial in facilitating the likelihood of quitting, is not essential to the success of NRT. We hope this Research Report will help readers understand the harmful effects of tobacco use and identify best practices for the prevention and treatment of tobacco addiction.

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RECOMMENDATIONS •

Brief counseling works better than simple advice to quit

•

Counseling with self-help materials offered by a trained clinician to the retailers can

improve cessation rates •

advertisement and free health campaigning will help

•

Encourage the patient

•

Anticipate problems or barriers

•

Express willingness to help

•

Ask about concerns or difficulties

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•

the continuing introduction and implementation of tobacco-control policies will

accelerate, further encouraging people to stop smoking, in turn increasing the use of smoking cessation products •

regular training and advice should be conducted for the retailers whenever there is a

negative feedback or report

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REFERENCES

Books  KOTHARY, Research methodology,2nd edition,2007  Naresh K. Malhotra , Introduction to Market Research  Walker-Mullins-Boyd-Larreche, Marketing strategy, 5th edition, TATA Mc

graw- Hill  “Marketing Management”, by Keller Kotler Website Referred •

www.cipla.com

•

Smoke-Free Families (www.smokefreefamilies.org)

•

Treating Tobacco Use and Dependence

•

Agency for Healthcare Research and Quality (www.ahrq.gov) •

www.wikipidea.com

Search engine •

www.google.com

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APPENDIX (QUESTIONAIRES) PATIENTS SURVEY NAMEAGEADDRESSMOBILE NO.1. How soon after you wake up you smoke your first cigarette? a) Within 5 minutes

c) 31-60 minutes

b) 6-30 minutes

d) After 60 minutes

2. Do you find it difficult to refrain from smoking in places where it is forbidden, e.g. in church, at the library, in a cinema, in temple, etc.? a) Yes

b) No

3. Which cigarette would you hate most to give up? a) The first one in the morning

b) Any other

4. How many cigarettes per day do you smoke? a) Less than or upto 10

c) 21-30

b) 11-20

d) More than 31

5. Do you smoke more frequently during the first hours after awakening than during the rest of the day? a) Yes

b) No

6. Do you smoke if you are so ill that you are in bed most of the day?

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a) Yes

b) No

7. How long you are smoking? a) Less than 1 year

c) Less than 10 years

b) Less than 5 years

d) Less than 15 years

8. Do you want to quit smoking? a) Yes

b) No

RETAILERS SURVEY NAME OF THE CONCERNED PERSONMOBILE NO.6. Do you smoke? a) Yes

b) No

7. Which is the highest selling brand for Nicotine Replacement Therapy (NRT)? a) Nicotex

c) Chempix

b) Nulife

d) Nicogum

8. Do patients come directly and ask for any medicine to quit smoking? a) Yes

b) No

9. How many patients buy medicine (NRT) regularly?

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a) Less than 5

c) Less than 15

b) Less than 10

d) Less than 20

10. Do you want to get associated in efforts of making quit smoking? a) Yes

b) No

11. Any queries asked by patients? If any _____________________________________________________ ____________________________________________________

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