Prescriptions for cigarettes in Iceland? Hippocrates would be rolling in his grave

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The parliament in Reykjavik, Iceland is considering some radical tobacco legislation: banning the sale of cigarettes from the usual retail outlets and allowing only pharmacies to sell them. As part of a 10-year plan, cigarettes would be legal to purchase only from pharmacies to those over the age of 20; eventually, only those with a doctor s prescription would be allowed to buy them.

The bill is sponsored by former health minister Siv Fridleifsdottir and would aim to increase cigarette prices by 10 percent annually; it would classify nicotine as an addictive substance, while tobacco smoke would be considered a carcinogenic substance and restricted accordingly. Prior to freely dispensing cigarette prescriptions, however, physicians would be required to help smokers quit via treatment and education programs.

But the chances are slim that this proposal will actually be passed into law, according to Anna Baldursdottir, a political advisor to the minister of welfare. Morally speaking, ACSH s Dr. Ruth Kava believes the practice of prescribing cigarettes would violate a physician s pledge to do no harm. How can doctors write scripts for cigarettes and still maintain that they do no harm? she asks. With other addictions, the addicted substance is replaced by a non-toxic substitute. But in this scenario, it d be akin to giving heroin addicts more heroin instead of methadone.

Essentially, this tobacco proposal amounts to the dictum quit or die, says ACSH's Dr. Gilbert Ross. It s almost magical thinking to pretend that if you make it hard for smokers to obtain cigarettes legally, that they ll just quit we know that s false. He adds, This whole misguided idea relates to the belief that supplying smokers with treatment and education programs is miraculously going to work to get them to quit in Iceland when these methods have failed miserably everywhere else except in Sweden, where snus is used successfully.