Chris Steele (doctor) - Fight To Have Nicotine Gum Prescriptions Paid By NHS

Fight To Have Nicotine Gum Prescriptions Paid By NHS

In 1984, the he was faced with a dilemma regarding the prescribing of nicotine gum (Nicorette) for smokers who wanted help in giving up their cigarettes. At that time in the UK, nicotine gum was a prescription only medicine (a POM). It was in fact the only POM amongst thousands that could not be prescribed at NHS expense, in other words it was not reimbursable under the socialised medicine system that was in effect at that time in the UK.

A Department of Health committee, known as the Advisory Committee on Borderline Substances recommended that Nicorette should not be allowed on NHS prescription, because it decreed that "Anti smoking preparations are not regarded as drugs." Dr Steele regarded that nicotine was most certainly a drug and a powerful one at that, and so prescribed nicotine gum on NHS prescriptions for those motivated smokers who wanted to give up smoking. As a result of "breaking the rules", Steele faced various disciplinary hearings eventually having to present his case to a Tribunal of Independent Referees.

At that tribunal a statement for the Secretary of State for Health read as follows: "Smoking is a habit it is not a disease or condition even though It may be a contributary cause of, or may aggravate, a disease or condition such as bronchitis, carcinoma of the lung, arteriosclerosis and so on." The tribunal's conclusions to "Is tobacco dependency a disease?", dated 6 July 1984, which Steele's supporters regarded as a vindication, were as follows:

• We find it ought to be so considered.
• We find that nicotine prescribed for this purpose has both a pharmacological and a therapeutic effect.
• We find that this method of treatment is the most effective that has so far been evolved.