The shift from smoking to smokeless nicotine addiction. Suppose there was a pill that did nothing bu

The shift from smoking to smokeless nicotine addiction. Suppose there was a pill that did nothing bu

This new model proposes that patients who cannot quit tobacco on their
own - or after using the smoking cessation product according to how it
was tested, approved, and labeled - be placed on continuous treatment.
The article contains a case study of a woman who returned to smoking
after her insurance company refused to continue paying for nicotine
inhalers after two years. The pressure-the-payer objective of the
article could not be clearer: "Although long-term use is considered
off-label, patients should be encouraged to remain smoke-free, and if
extended courses of pharmacotherapy will assist them, treatment should
be continued, encouraged, and reimbursed."

Reclassifying a dangerous habit as a chronic disease so that insurance
companies will pay for nicotine replacement drugs to be taken
off-label forever would transfer the financial burden for the
patients' nicotine fix from the patients to their insurance companies.
Alternatively, patients could take expensive cessation drugs without
the nicotine, but with known serious adverse effects, for the rest of
their lives.

* w w w .bioethicsforum.org/smoking-tobacco-chronic-disease-drug-treatment.asp