Experts Not in Favour of Nicotine Replacement Therapies being Reclassified as Prescription Drugs

NEW DELHI, OCTOBER 07, 2023:  With tobacco addiction becoming an increasingly critical concern, responsible for over a million deaths and constituting 9.5% of all fatalities in the country, healthcare professionals are stressing the importance of a comprehensive approach. This multifaceted strategy includes improving the availability of tobacco cessation methods, public education, and the use of approved therapies like Nicotine Replacement Therapy (NRT). NRT has been a key player in this fight for over 25 years, offering a 50% higher success rate in quitting smoking compared to unassisted attempts. Importantly, it is accessible without the need for a prescription, ensuring it’s readily available to those in need.

Dr. Chandrakant S Pandav, Former Head, Department of Community Medicine, AIIMS, New Delhi & Recipient of Padma Shri Award, highlights the urgency of enhancing access to tobacco cessation methods in India, saying “Tobacco use affects 28.6% of adults in the country, with a particularly significant impact on 42% of men and 14.2% of women. These challenges persist in remote and rural areas, making it imperative to make NRT available over the counter (OTC). Easier access to NRT empowers individuals to quit smoking effectively.”

Nicotine, the primary addictive component in cigarettes, delivers rapid pleasurable effects when smoked. In contrast, NRT serves as a temporary substitute for nicotine, helping control cravings, alleviate withdrawal symptoms, and facilitate the transition to tobacco-free living. Unlike cigarettes, NRT ensures a gradual and controlled increase in blood nicotine levels, discouraging misuse.

Dr. Sajeela Maini, Head, Tobacco Cessation, De-addiction & Mental Health Expert, Sir Gangaram Hospital, New Delhi, emphasises “Nicotine Replacement Therapy is the cornerstone of Smoking Cessation Therapy. Replacing cigarettes with nicotine products is the most effective approach to reduce cravings and withdrawals. We must address both the physiological and psychological aspects of tobacco addiction to ensure successful cessation. To achieve this, we must focus on improving access to NRT.”

Recent trials conducted in India in 2023 have showcased the effectiveness of NRT in curbing smokeless tobacco use, a specific issue in the country. Additionally, combining NRT with behavioural counselling has proven successful in reducing cigarette smoking.

Dr. Maini further emphasises the critical role of NRT in addressing nicotine addiction, highlighting, “It provides a systematic and safe means of delivering nicotine to the body. Various forms of NRT, including nicotine patches and gums, are customised to individual smoking levels, ensuring that nicotine addiction can be managed without the need for cigarettes.”

India’s commitment to tackling tobacco addiction, as demonstrated by its recognition of NRT’s importance in the National List of Essential Medicines (NLEM) in 2022, was a step in the right direction. This recognition paved the way for insurance coverage, public sector supply, and integrated medical-dental support for tobacco cessation. With NRT serving as a crucial first-line therapy, India is striving to achieve its goal of reducing tobacco use by 30% by 2025.

As India works towards a healthier future, providing millions with a fighting chance against addiction is paramount. The accessibility of NRT over the counter will serve as a litmus test for the nation’s commitment to combating tobacco addiction.

However, the recent proposal by the Drugs Technical Advisory Board (DTAB) to reclassify NRT as prescription-based, rather than OTC, has sparked a significant debate. Experts argue that such a move could reverse progress in the battle against tobacco addiction and go against recommendations from leading global health authorities.

Reclassifying tobacco as a prescription drug would limit accessibility for prospective quitters and hamper the government’s efforts on tobacco de-addiction. India’s 100+ million smokers contribute to over 20% of global tobacco-related deaths, impacting families, livelihoods, and national productivity. This poses a challenge to campaigns like ‘Make in India’ and ‘Atmanirbhar Bharat’ focused on self-reliance and economic growth.

Corporate Comm India (CCI Newswire)