Source: Sydney Morning Herald (au)
Date: 2010-02-11
Author:  JULIE ROBOTHAM

But what if nicotine replacement therapy was really a perfidious
ally, capable of understanding and support, but also apt to
undermine?

Simon Chapman believes scientists, governments, and smokers
themselves have fallen too hard for the nicotine replacement
doctrine.

The professor in public health at the University of Sydney, who
is a long-time anti-smoking advocate, says the pharmaceutical
industry\'s line that gums and patches improve the likelihood of a
successful attempt to quit may be true in the rarefied world of
clinical trials, where smokers receive their products free and
have their progress painstakingly monitored by researchers.

But it ignores the evidence that up to three-quarters of former
smokers have quit without formal assistance, Chapman says, and in
most cases without much difficulty.

The Nicabate and Nicorette franchises of GlaxoSmithKline and
Pharmacia & Upjohn are highly visible juggernauts. . . .

But a trawl this week through health campaign websites reveals
some messages that would surely delight sponsors of nicotine
replacement therapy.

NSW\'s Quitline, for example, urges smokers to "Plan ahead to
deal with temptation. Keep a record of every cigarette so that
you can identify certain situations where you feel tempted ...
You should also speak to your doctor to discuss the different
medications that are available that can help you stop smoking."

Chapman says the idea that giving up needs to be approached as a
precision exercise, complete with diary, does not stack up. He
says smokers should be told that many people who quit unassisted
do so on a whim, without planning, and most find it less
traumatic than they expect. . . .

Chapman believes it is therefore not unreasonable to recommend
multiple approaches, including nicotine replacement for those
well suited to it.

But that is an argument that fits Australia and other rich
developed nations much better than it does poorer countries