Two new reports have proposed that pharmacists dispense smokeless tobacco products in a bid to help patients quit cigarettes.
Public health experts writing in this month's
Medical Journal of Australia argue that "snus", an oral tobacco product that is illegal to manufacture and sell under laws introduced in 1991, should be sold under the counter in pharmacies and that pharmacists should encourage smokers to switch to the product as a way of reducing the harm caused by their cigarette use or as an additional path to quitting.
"Trials of allowing LNST (low nitrosamine smokeless tobacco) products to be scheduled S3 and made available under the counter from pharmacies offer a model of highly controlled access that could be investigated," one author wrote.
"Pharmacists who might baulk at the thought of dispensing a tobacco product can reflect on the many precedents already embraced in medical practice, where lower risk agents and procedures are prescribed or implemented in the hope of achieving more important health benefits than the risks being posed by treatments and (for example) diagnostic radiation."
The authors argue that snus may be a more effective cessation aid and a more attractive long-term alternative to cigarettes than pharmaceutical nicotine because its nicotine delivery and social aspects are similar to those of smoking.
Snus use may increase the risk of pancreatic cancer and pose other health risks, but studies suggest that any such risks will still be much lower than those of smoking, the authors say, adding that recent epidemiological modelling indicates that there are only small differences in life expectancy between smokers who quit and those who switch to snus.
What do you think? Would you dispense smokeless tobacco products? Comment here.