Iceland Mulls Selling Cigarettes By Prescription Only

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Icelanders hoping to light up may soon need a note from their doctor.

Siv Fridleifsdottir, the country’s former health minister, has proposed a radical bill in parliament that would make cigarettes a prescription-only product, the U.K.’s Guardian reports. The bill would ban the sale of cigarettes in regular shops, allowing only pharmacies to dispense them. Initially sales would be limited to those 20 years and older, and later to smokers with a valid medical certificate.

If the measure passes, it would encourage smokers to try to quit, by working with doctors and addiction treatment and education programs. If those efforts fail, doctors would be able to prescribe cigarettes.

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The proposal is part of a larger 10-year plan that also seeks to ban smoking in all public places — including parks and sidewalks — and cars carrying children. Over the past 20 years, Iceland has cut smoking rates in half, from 30% in 1991 to 15% today. The reduction is largely due to a large increase in tobacco taxes, which account for 25% of the cost of a pack, and belt-tightening in the wake of Iceland’s financial collapse.

As part of the proposed legislation, the price of cigarettes would rise by another 10%, enough of a hike to help reduce smoking rates 4%-8% further, according to previous evidence. “The aim is to protect children and youngsters and stop them from starting to smoke,” Fridleifsdottir said on July 4.

But eventually, the price of prescription cigarettes would drop; by the end of the 10-year period, they would be even cheaper than the current cost of 1,000 krona (about $8.75) per pack. “Under our plan, smokers who are given prescriptions will be diagnosed as addicts, and we don’t think the government should tax addicts,” Thorarinn Gudnason, president of the Icelandic Society of Cardiology, who helped draft the proposal, told the Guardian.

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The tobacco proposal aims to get nicotine classified as an addictive substance and regulated by the government like other drugs. It also says secondhand tobacco smoke should be restricted like other known carcinogens and harmful substances. Previous policies have had a demonstrable effect, Gudnason said. In the five months after Iceland banned smoking in restaurants and pubs in 2007, for instance, heart attacks in nonsmoking men dropped by 21%.

Of the 1,500 deaths in Iceland each year, 300 result from lung cancer, heart attack and chronic obstructive pulmonary disease — all known consequences of smoking. “That’s 20% of all deaths,” Gudnason said. “We think that our proposals could lead to a significant reduction in smoking-related deaths — perhaps down to just 100 annually.”

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