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Paying for nicotine replacement therapy is cheaper
than smoking 20 cigarettesand under a day
Editor -
Fowler and Smeeth propose making nicotine replacement therapy available
on the NHS, believing its high retail price remains prohibitive to many
people.([1)] A typical eight week course
of patches of 21mg/24 h bought from a pharmacy costs £17 a week,
but smokers of 20 cigarettes a day will save roughly £20 a week
through not smoking while using the patches.
In the Cochrane systematic review of 47 trials including 23,000 patients,
nicotine replacement therapy doubled smoking cessation rates at 6-12 months
compared with placebo.([2)] The authors
point out, however, that the absolute probability of abstinence for an
individual remains low, and 15 patients would have to use nicotine replacement
to produce one extra abstainer. There seems to be evidence of publication
bias against negative trials and that compliance with nicotine replacement
was lower among smokers treated in primary care.
The editorial overlooks the fact that smokers save money even while paying
for their nicotine replacement therapy. This should be borne in mind before
yet more pressure is added to the already strained NHS prescribing budget,
and motivated smokers who are using the skills of community pharmacists
are encouraged to involve their general practitioner instead.
Reference
1 Smeeth
L, Fowler G. Nicotine
replacement therapy for a healthier nation.
BMJ 1998;317:1266-7. (7 November.)
2 Silagy C, Mant D, Fowler G,
Lancaster T. Nicotine replacement therapy for smoking cessation. In: Cochrane
Collaboration. Cochrane
Library. Issue 2. Oxford: Update Software, 1998.
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