Iceland, in a radical attempt to curb the number of deaths due to smoking-related illnesses, is considering a 10-year plan which would eventually make cigarettes available only with a doctor’s prescription. The only people who would be able to access cigarettes would be those who were deemed unable to end their cigarette habit. The plan would also ban smoking in all public places and in cars where children were present.
Ironically, although the plan would begin with tax increases on cigarettes, by the time a decade passed and cigarettes were prescription-only, they would actually be cheaper than ever. ”Under our plan, smokers who are given prescriptions will be diagnosed as addicts, and we don’t think the government should tax addicts,” explained Thorarinn Gudnason, the president of the Icelandic Society of Cardiology.
He explained that cigarette pricing did not include the heavy cost to society that came with smoking-related illnesses. ”A packet currently costs around 1,000 krona [around $9], but if you factor in the cost of sick leave, reduced productivity due to smoking breaks and premature retirement on health grounds, it should really be 3,000 krona,” he said.
Nicotine would be treated like other addictive drugs, and cigarettes would be licensed as a medicine. Although some elements of the plan have been attempted before, with great success (the WHO estimates that every 10% price increase reduces tobacco consumption by 4-6%), but the prescription idea is completely new. Gudnason says that he sees Iceland as a testing ground for the idea.
One doctor raised the question of whether making cigarettes prescription-only would make a physician an “accomplice to a health hazard decision.” It’s a fair point – how would doctors be able to balance a patient’s need for cigarettes with the knowledge that prescribing them could lead to a deadly illness down the line?
The Icelandic government says that the plan is serious, but that it’s also unlikely to pass. Because Iceland already has one of the lowest smoking rates in Europe, after an extremely successful tobacco tax, which cut regular smoking rates in half, it may not be as urgently necessary as in other countries. It could also be easier for Iceland, because it’s remote and isolated, to enforce a ban on cigarettes, since they would be more difficult to smuggle.
What do you think? Is it a good idea to raise taxes on tobacco, completely ban smoking in public, or make cigarettes prescription-only?
Photo from emiemihuimei via flickr.