Puffers get patches, not pills

By MARTIN JOHNSTON health reporter

Smokers wanting to use Government money to help them quit may not be able to spend it on a new pill claimed to be more effective than subsidised nicotine-replacement therapy.

Drug company Glaxo Wellcome has just launched the quit-smoking tablet, Zyban, in New Zealand pharmacies.

Costing about $50 for a week's supply and requiring a doctor's prescription, Zyban could set smokers back $600 as it needs to be taken for seven to 12 weeks. Nicotine patches cost about $130 a month.

The Government plans next summer to subsidise patches for moderate to heavy smokers for up to eight weeks at a cost to patients of about $20.

A Health Ministry spokeswoman said yesterday that Zyban was not being considered for inclusion.

This was because most types of nicotine replacement could be obtained without a doctor's prescription and Zyban "does have some side-effects. It needs monitoring."

Glaxo medical director Dr Ian Griffiths said he was surprised the ministry would not consider something with the success rate of Zyban. "They move in mysterious ways."

He said Zyban was developed as an anti-depressant. It was discovered by accident that smokers using it stopped smoking.

The drug's most common sideeffects are listed as dry mouth and insomnia, and they are mild and transient.

Dr Griffiths said another sideeffect, though rare, was seizures so Zyban was not prescribed to people at risk of seizures, including victims of severe head-injury.

Despite the knockback, Glaxo is applying to Pharmac, the usual route for subsidies on medicines.

Anti-tobacco groups welcomed the drug as a new weapon in the fight against smoking.

Half of adult Maori and a quarter of the adult population smoke.

Associate Professor Boyd Swinburn, chairman of the Smokefree Coalition, said he had not seen cost-benefit studies on Zyban but he expected they would show it was very effective and should therefore be subsidised.

A Glaxo-supported American trial involving 900 people found 30.3 per cent of Zyban patients were not smoking a year later - compared with 16.4 per cent of those using nicotine patches and 15.6 per cent of those using a placebo.

Dr Swinburn said it was a good study but he questioned the apparently poor performance of patches since other studies had shown they were effective.