Ireland: Free nicotine replacement therapy in specialist services

On 22 February 2023, the Health Service Executive (HSE) announced that nicotine replacement therapy (NRT) is now free in smoking cessation settings; this is part of a package of support available to people who want to quit smoking through the agency's QUIT service.[1].

In 2022, almost one in five adults smoke in Ireland, a prevalence that has remained stable since 2019.

The effectiveness of nicotine replacement therapies

The HSE points out that NRTs are authorised medicines that safely deliver levels of nicotine, tailored to smokers’ profiles, to help smokers overcome withdrawal and craving symptoms. These treatments therefore increase the chances of quitting smoking permanently. NRTs come in many different forms, including patches, gums, lozenges, inhalers and mouth sprays, and are often more effective when used in combination. For example, using a long-acting patch in combination with a short-acting nicotine mouth spray or lozenge.

Dr Paul Kavanagh, HSE's Medical Officer for Public Health in the Tobacco Free Ireland programme, points out that using NRT for 12 weeks doubles the chances of quitting smoking, when combined with pre- and post-quit support from HSE trained counsellors.

A coherent set of measures to reduce smoking in Ireland

Ireland aims to achieve a tobacco-free generation by 2025. In early 2022, the country unveiled a new set of recommendations and best practices for healthcare professionals. The aim was to help them advise and support smoking patients in quitting smoking and preventing relapse in order to achieve this goal. Particular attention is paid to more vulnerable populations where smoking prevalence is three times higher than that of more affluent population groups. The country also wants to develop its tobacco-free spaces (campuses, sports facilities, healthcare facilities, etc.) in order to denormalize smoking and protect the youngest.[2].

While its English neighbour has integrated vaping devices as a smoking cessation tool in its strategy to reduce smoking, Ireland is breaking away from this position and has decided to put in place new restrictions around these products, particularly concerning the sale and advertising.[3]The new proposals will be included in the next Public Health Bill to be published in 2023. They aim to ban the sale of vaping products to under-18s and introduce a licensing system for the retail sale of tobacco and vaping products. The sale of e-cigarettes will also be banned from self-service vending machines, temporary or mobile premises and at venues or events aimed at children. In addition, advertising for e-cigarettes will be banned on public transport, in cinemas and near schools.

Irish Health Minister Stephen Donnelly, who said he was concerned about the variety of flavours available for vaping products, said the bans were necessary to limit young people's exposure to vaping advertising and prevent them from starting to use the products. Ireland is also considering banning disposable e-cigarettes, known as puffs, which have become very popular among teenagers.

Keywords: Ireland, TSN, nicotine replacement therapy, cessation, smoking, healthcare professional, vaping,

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