I agree with Sherry Tingley in her analysis that politics would seem to be
driving policy and it is policy that considers the public good
secondarily.  As an observer and researcher interested in health policy,
health promotion and in paticular the delivery of health services from a
patient- centered / need perspective I have great concerns.

Regarding nicotine patches, it would seem to me that this situation has a
number of lessons for those interested in politics, policy and consumer
interests.  It is my understanding that these patches need to be used with
great care.  I remember when they were first on the market a number of
deaths resulted, usually when people continued to smoke or had
heart problems. There is a substantial body of evidence that demonstrates
the value of support and consultation when attempting to beat on
addiction.  It would make a great deal of sense for patches to require
soom consultation and monitoring.

 While the campaign to end smoking is massive I am not so certain that
such easy access to nicotine patches is truely going to benefit the
consumer or significantly aid in smoking censsation.

I will go on to say I am truly amazed (as an observer) at how smoking
cessation programs and research generally would seem to take little
advantage of research and practice related to addictions.  The consumer,
client is loosing out when best practice and policy is not made a
priority.

Jayne Cardno
Rural Extension Studies
University of Guelph