Should the state provide free nicotine replacement?
December 28, 2010 3 Comments
At first light you would probably say, what a good idea. Smoking costs the NHS lots of money so why not a bit of encouragement? Well why? If you can afford to smoke you can certainly afford the various replacement schemes on offer.
If the state will pay for that will they actively fund the diet I will start next week. It will cost over £40 a week. But hang on. I used to buy food and now I will but this. Success isn’t down to whether the state pays for it but whether the will power is there. That applies to dieting just as it does to give up smoking. And let’s not forget that obesity related diseases will cost the NHS more than solely smoking related diseases, so if it’s a cost benefit issue I claim my money now please.
But I jest, for if I want to make a change that will be good for me, and will not lead to a greater expense (the same as giving up smoking) I do not need the state giving me a hand out to do it.
Tory Radio 
The UK government has to make choice. It has to either ban smoking completely and pay for everyones quit programme or stop spending money on public health projects such as this whilst still saying it is acceptable to smoke.
Not sure why it would ban it completely? Why not ban alcohol and indeed fatty soods as they cause damage to individuals and cost the NHS millions. I'm all for a state which guides you to take more personal responsibility, rather than one which feels the need to intervene after every action you take.
The main difference is that with smoking (and other drugs) you are able to control a consumption problem by simply avoiding the material. Whereas with food you can't just stop eating. You must enter into a healthy long-term relationship with food in order to control an over-eating problem and mitigate potential future medical implications. Therefore, a food-related problem is a lifetime commitment to cure whereas smoking has a fixed goal.
In my own case I would have appreciated support from the healthcare sector. I was paying over £70 per week for my weight loss programme and it genuinely worked with no health effects. However, some GPs refuse to sign patients off on the diet plan and some charge upwards of £80 per session to monitor a patient who is on the plan. It's not just the plan I follow either. And it's not just GPs. I've had times when a pharmacy worker refused to carry out a blood pressure check as part of the NICE recommended monitoring of any weight loss programme because I was on a weight loss programme.
So you see it's not as simple as doing something like paying patients to lose weight, paying for gastric bands or even a fat tax. The whole healthcare system in this country has got to change its attitude to provide the kind of medical treatments and interventions that the population needs. So long as our system continues to follow some apparently ancient ideals about food and our relationship with it there will never be the focus on obesity that it deserves.
What could have been done in my case? What do I think needs to change? To start with, having lost nearly 9 stone in 6 months it would be nice to be able to tap into a support structure to make sure the weight doesn't come back as old habits start to kick in again. There's no support out there at the moment for people like me and yet if we are helped now it will prevent problems in the future. The commercial people who helped us get the weight off in the first place aren't long-term hand-holders. In fact, they'll welcome us and our money back in a few months when the weight comes back on. And so starts the cycle of weight gain and loss that lines their pockets.
I don't have answers and I've mostly just ranted here. But I hope I've made a few points and given some food for thought, if you'll pardon the pun.