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Enabling access to new WHO essential medicines the case for nicotine replacement therapies.doc

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Enabling access to new WHO essential medicines the case for nicotine replacement therapies

Kishoreetal.GlobalizationandHealth2010,6:22 /content/6/1/22 COMMENTARY OpenAccess EnablingaccesstonewWHOessentialmedicines: thecasefornicotinereplacementtherapies SandeepPKishore1,5*,AsafBitton2,AlejandroCravioto3,DerekYach4 Abstract Nicotinereplacementtherapies(NRT)arepowerfultoolsforthesuccessfultreatmentofnicotineaddictionand tobaccouse.Themedicinesareclinicallyeffective,supportedbytheFrameworkConventiononTobaccoControl, andarenowWorldHealthOrganization-approvedessentialmedicines.EnablingglobalaccesstoNRTremainsa challengegivenongoingconfusionandmisperceptionsabouttheirefficacy,cost-effectiveness,andavailabilitywith respecttoothertobaccocontrolandpublichealthopportunities.Inthiscommentary,wereviewexistingevidence andguidelinestomakethecaseforglobalaccesstoNRThighlightingthesmoker’srighttoaccesstreatmentto sensiblyaddressnicotineaddiction. Tobaccousekills5.4millionpeopleannually.Evenifno foundations and major charities base their medicine childrenstartedsmokinginthefuture,8.3millionpeo- supplyontheWHOEML.Medicinesnotontheinter- plewilldieannuallyoftobacco-relateddiseasesby2030. national ornational EMLareoften notavailable orare Unless tobacco cessation and control vastly improves, simplyunaffordableinLMIC. thedeathtollfromtobaccothiscenturywilleasilyreach Inthiscontext,wearguethatinlightoftheincreasing anestimated 1billion deaths [1]. Inthis paper, wedis- global burden of tobacco dependence and the clinical cuss the benefits and challenges of enabling access to utilityofNRT,thesenewWHOessentialmedicinescan pharmacotherapies [nicotine replacement therapies andshouldbeavailable morewidely. Let usbeclear at (NRTs)] to treat nicotine dependence and bolster the outset. We do not argue that every smoker in a tobacco cessation in low and middle income countries given population should use NRT to quit. Rather, we (LMIC). posit that a nicotine-dependent individual in a low InMarch2009,NRTs(specifically,nicotinegumsand resourcecountrysh