Abstract
In April 2002, the National Institute for Clinical Excellence (NICE) released guidance on cost effective pharmacological treatment of tobacco addiction.1 This endorsement allows every health authority in England and Wales to provide nicotine replacement or bupropion for patients who are dependent on tobacco and request treatment. Whether smokers will ask for and receive these drugs depends on many factors. Two scenarios, from the United Kingdom and the United States, illustrate the struggle between the press and medical experts to investigate and report concerns about the safety of new drugs for smoking cessation and the effect this struggle has on reported attempts to quit smoking. The NHS advanced the treatment of the tobacco dependence movement with three initiatives: a white paper that established a priority for the treatment of tobacco dependence in 1998,2 a national plan for expanded smoking cessation services launched in 1999-2000, and the approval of bupropion in 2000 and nicotine replacement in 2001 for inclusion in the NHS reimbursement scheme. The Royal College of Physicians …

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