ASH declared interest in GlaxoSmithKline, 2001

In 2001, then head of Action on Smoking and Health Clive Bates wrote to the Chief Executive Officer of GlaxoSmithKline, protesting at the appointment of a tobacco industry representative Derek Bonham on its board of directors. Bates felt that a conflict of interest was involved: the public already in 2001 had identified collusion between pharmaceutical and tobacco interests:

There are already campaign groups that claim the tobacco industry and pharmaceutical industry have a symbiotic relationship that is parasitic on the smoker. I believe it would be highly damaging to the category, to the company and the industry as a whole would be highly damaging to feed that cynical perception.

News to me if the public had any such 'cynical' perception ten years ago.

The letter says:

1. that Action on Smoking and Health had a 'small holding' in GSK
2. that Action on Smoking and Health was instrumental in getting smoking cessation treatments accepted by the Department of Health in London

It identifies policy measures, such as raising prices and increasing regulation of tobacco, that benefit 'the smoking cessation market' at the expense of the tobacco market.  'Every time a smoker switches to "lights" as
an alternative to quitting the market for smoking cessation is diminished.' Clive's letter lists measures that he believes promote the smoking cessation market at the expense of tobacco:

• Restrictions on smoking in public places and workplaces
• Marketing restrictions on tobacco companies
• Higher tobacco taxation
• Greater NHS involvement in smoking cessation
• Regulatory measures to be applied to tobacco products.

Tobacco companies and pharmaceutical companies carrying nicotine replacement treatments are competing for the same market: that of smokers. To that extent, there is a logical conflict of interest.

Nicotine replacement therapies became available on the NHS in April 2001. The Guardian was excited about this move soberly  reporting John Britton's then-cautious estimate that NRT doubled a smoker's chance of quitting (the claim escalated to a quadrupling of the cold-turkey quit rate). In those days one could say:
'this doubled success rate only applies if you are ready to stop. Taking NRT cannot make you more committed to giving up smoking or transform you into a non-smoker, although it can help end the psychological habit of reaching for a cigarette.'

Even giving nicotine treatments to kids as young as 12 didn't raise any scepticism among Guardian writers on health.

The early days saw campaigners fighting for greater availability of NRT, using the same harm reduction arguments now used by campaigners for e-cigarettes. Said Anne McNeill (now at the UK Centre for Tobacco Control Studies): 'It's simple really - the more the regulators place stringent regulations on the use of NRT, the more likely it is that people will continue to smoke, and then die as a result.'

My question is – the smoking cessation market is important to Clive Bates. No doubt he believed it would help smokers to give up smoking. But what is it worth (as an investment) to the NHS, when it's clear that much of it will go out free on prescription?

Just asking.