By Richard Woodman
LONDON (Reuters Health) – Public health experts accused drug regulators on Thursday of endangering the lives of smokers by imposing stringent restrictions on the use of nicotine replacement therapy (NRT).
In a review in the journal Addiction, they said the existing regulatory framework restricts access to NRT even though the likely consequence is continued use of nicotine in a much more harmful form through smoking.
They called for restrictions and warnings that stop young people, pregnant smokers and smokers with cardiovascular disease using NRT to be removed. NRT should also be licensed for temporary abstinence–for example at work or in public places–as well as for complete smoking cessation.
Long-term use of NRT should be allowed, and NRT products should be made as widely available as cigarettes. "It's simple really–the more the regulators place stringent regulations on the use of NRT, the more likely it is that people will continue to smoke, and then die as a result," said lead author Dr. Ann McNeill, from the department of psychology, St. George's Hospital Medical School, London.
She told Reuters Health that the recommendations had been drawn up by a group of experts convened by the World Health Organisation after discussions with regulators in Britain, France, Germany and Poland. The recommendations would be presented at this week's WHO "public-private partnership in tobacco control" meeting in Prague.
Co-author Dr. Jonathan Foulds, of the University of Medicine and Dentistry of New Jersey, School of Public Health said in a statement: "We really need to liberalise the market for nicotine treatments and remove these absurd restrictions.
"In many countries of the world you need a doctor's prescription to get the nicotine inhaler but you can buy cigarettes almost anywhere. What kind of crazy system is it that makes it so much easier to get the most dangerous product and so hard to get the treatment?"
Fellow co-author, Clive Bates, director of the UK anti-smoking group Action on Smoking and Health, said, "It's easy to explain why the regulators adopt the ostrich posture when it comes to NRT products. If a smoker has a problem when using the drug, the regulator or medical professional might be blamed. "
He added, "If the regulator or medical professional was liable for the consequences of not treating a smoker with NRT, we'd soon see these restrictions come off."
Source: Addiction 2001;96:1757-1768
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