Adriane J. Fugh-Berman, MD; Douglas Melnick, MD, MPH
Potential Financial Conflicts of Interest: Dr. Fugh-Berman has been a paid expert witness on the plaintiff's side in litigation regarding pharmaceutical marketing practices.
Fugh-Berman A., Melnick D.; Is Long-Term Use of Antismoking Drugs Consistent with Public Health Goals or Pharmaceutical Marketing Goals?. Ann Intern Med. 2008;149:838. doi: 10.7326/0003-4819-149-11-200812020-00016
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Published: Ann Intern Med. 2008;149(11):838.
TO THE EDITOR:
A recent article by Steinberg and colleagues (1) argues that tobacco dependence should be considered a medical disease, like asthma or diabetes. Steinberg and colleagues argue that the smoking habit deserves chronic disease status, and that long-term drug treatment, despite being an off-label use, should be reimbursed.
Smokers should be encouraged and supported to quit smoking, with short-term pharmacologic aids if necessary. Long-term use of products that have not been tested or approved for long-term use, however, is inconsistent with public health goals while being consistent with pharmaceutical marketing goals. We note that 2 authors of the commentary are on the speaker's bureau of Pfizer and are consultants to Pfizer, Novartis, GlaxoSmithKline, and Celtic Pharma. Pfizer makes Chantix (varenecline) and Nicotrol nasal spray. GlaxoSmithKline makes Nicorette gum, Commit nicotine lozenges, Nicoderm nicotine patches, and Zyban (bupropion, also sold as Wellbutrin). Novartis makes Thrive, a nicotine chewing gum. Celtic Pharma is developing TA-NIC, a nicotine vaccine.
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