Background:
Free or lower cost cessation medication is reported more often as a trigger to think about quitting by smokers with low education and/or income, but it is not clear whether this leads to actual quitting of smoking. The aim of this study was to investigate whether reporting free medication as trigger is related to medication use, reported quit attempts and quit success and whether this association is modified by education and income.

Methods:
Data were derived from the 2013 and 2014 surveys of the International Tobacco Control (ITC) Netherlands (n=1164) and United Kingdom (n=768) cohort. From the 2013 survey, current smokers were selected who also participated in the 2014 follow-up survey. Logistic regression analyses were used to assess associations between free medication as a trigger to think about quitting in 2013 and the use of smoking cessation medication, quit attempts and smoking cessation in 2014.

Results:
37.0% of smokers in the UK and 24.9% of smokers in the Netherlands reported free or lower cost medication as trigger to think about quitting. Smokers who reported this trigger were more likely to have used cessation medication during a quit attempt both in the UK (OR = 4.19, p < 0.001) and in the Netherlands (OR = 2.14, p = 0.033). The association between free medication as trigger to think about quitting and quit attempts was significant in the UK (OR = 1.45, p = 0.030), but not in the Netherlands (OR = 1.10, p = 0.587). There was no significant association with quit success. Associations did not differ across income and education groups.

Conclusions:
Free or lower cost smoking cessation medication may stimulate quit attempts and increase the use of cessation medication among smokers with low, moderate, and high socioeconomic status.