Free therapy to smokers loses out to 'other priorities'

Providing free nicotine replacement therapy to smokers was not a policy the government was presently considering, according to the director general for health, Ray Busuttil.

Dr Busuttil explained that in an ideal world NRT should be given free of charge to smokers. However, the government had other priorities on its agenda at the moment.

"Of course NRT is helpful but giving it free has to be considered in the light of multiple other requests for free treatment and the cost of new medicine and treatment which emerge every day," he said.

Dr Busuttil was asked to comment on the recommendations made by Mario Sammut, a senior medical officer at the Department of Primary Health Care, in May's edition of the Malta Medical Journal.

Dr Sammut carried out an evaluation of smoking cessation clinics in Malta to determine their success and among others recommended that NRT be available free on prescription to step up the clinics' present success rate of just 10 per cent.

The study showed that the UK and the US had higher success rates - 20 to 30 per cent and 15 to 30 per cent respectively - because they had put NRT at the cornerstone of therapy, while Maltese smoking cessation clinics left the choice and cost of NRT to would-be quitters.

His study also uncovered a very interesting detail - the consequent savings for lung cancer treatment were conservatively estimated at Lm3,245 per quitter in the first year of diagnosed disease.

This figure is more than five times the clinics' running costs over one year.

When confronted with this figure, Dr Busuttil agreed that in the long-term NRT would save the government a lot of money, but at the moment this money was being spent in more important areas.

He also pointed out that while smokers were prepared to spend at least Lm1.25 a day on a packet of cigarettes, they had great difficulty forking out money for NRT.

V.J. Salomone Pharma Limited, one of the importers of NRT, highlighted the cost for products designed to ease the cravings and nicotine intake gradually: Lm8.06 for a seven-day packet of nicotine patches and Lm7.98 for a week's supply of chewing gum.

Last week, 192 countries, including Malta, unanimously approved the first international treaty against smoking, including an advertising ban aimed at kicking the deadly habit, at the World Health Assembly, the annual meeting of the World Health Organisation.

Asked if this Framework Convention on Tobacco Control specified the need to provide NRT for free, Dr Busuttil said the promotion of smoking cessation was a crucial part of it.

"The government is committed to smoking cessation and it already offered free smoking cessation clinics. The next step would be free NRT, but this is not a priority yet," he said.

Meanwhile, when contacted Health Promotion Department director Mario Spiteri said several statistics showed that NRT was successful in helping smokers kick their habit.

"Free NRT would be instrumental in helping smoking cessation clinics achieve a higher success rate. However, the government still considers this a costly supplement to provide free of charge," he said.

Dr Spiteri pointed out that while smoking was considered a capricious habit, and therefore free NRT was not a priority, on the other hand heroin addicts were provided with free methadone to quit.

However, NRT was not the be all and end all of quitting, and the department was focusing its energies on alternative therapy, including one-to-one counselling.

Dr Spiteri said this type of counselling, which was the preferred option for an average of 40 smokers a month, had a success rate of over 75 per cent.