POLL of the DAY (50): DOCTOR KNOWS BEST?

As reported in the New York Times this week 'Doctors typically wait until smokers are ready to quit before prescribing pills to help them do it. But a new study has found that even for those who are not ready to stop smoking immediately, medicine taken over time can substantially improve their chances of eventually quitting.

David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies, said studies of nicotine replacement therapy, such as patches and gum, had long shown that attempts to quit gradually over time are a good way to change lifetime habits. The current study appears to show the same for pills, he said.

“Sometimes serious addiction needs to be coaxed down the stairs one at a time, not thrown off the top floor,” said Dr. Abrams, who was not involved in the study.

The study was funded by Pfizer, the drug company that makes Chantix, a treatment that costs about $250 a month. Federal regulators require companies to conduct studies proving the effectiveness of such therapies, and monitor them closely. The practice is common for smoking cessation therapies, said Robert West, director of tobacco studies at University College London, who was among the study’s authors. If such studies were funded by the government, which sustains a lot of academic research, taxpayers would bear the burden for what the company would eventually profit from, he said.

Still, some researchers not involved in the study said the topic required more work.

Gary A. Giovino, a professor of health behavior at the State University of New York at Buffalo stated “But the findings from one study do not make a fact. We need more studies, funded by someone other than the company that makes the product.”

Smoking is the largest cause of preventable death in the United States, killing more than 480,000 Americans a year. The smoking rate has declined substantially since the 1960s, but the pace of decline has slowed in recent years and health experts are trying to figure out how to get more smokers to quit.

The study’s authors said the findings had the potential to change practice.

“It’s a paradigm shift because instead of only giving the medication to patients who have set a quit date, you are potentially giving it to every smoker,” said Dr. Jon O. Ebbert, one of the authors, who is a professor of medicine at the Mayo Clinic College of Medicine in Minnesota. “It opens the door to a much larger population of smokers that we can treat.”

Read the article in full here: http://www.nytimes.com/2015/02/18/health/pills-found-to-help-chances-of-quitting-smoking-in-the-future.html?action=click&contentCollection=Health&region=Footer&module=MoreInSection&pgtype=Blogs

While assisting those who wish to give up smoking can be seen as an important aspect of a health professional's role, is it appropriate to also treat patients who have not asked for smoking cessation help? 

Is prescribing medication to all smokers good health promotion practice or heavy handed paternalism?

What do you think?

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