Sir - I note with interest your editorial (September 17th) on Viagra in which you state that it should be available on prescription in the General Medical Services for reasons of non-discrimination, safety and health protection. Be that as may, I would suggest that if we are seriously concerned with public health and cost-effective health care, there are other more deserving cases which need to be championed.
One that immediately springs to mind is the non-availability of nicotine replacement therapy for smokers in the General Medical Services. There are between 800,000 and 1 million smokers in Ireland, many of whom have tried unsuccessfully to quit. Nicotine replacement therapy has been shown to be a safe, effective and extremely cost-effective means of helping smokers break their addiction to smoking, yet it is not available to those who need it most. Smoking kills 6,500 Irish people every year and that figure will not fall significantly over the next 10 years unless there is a concerted effort to assist tobacco addicts to quit. Making nicotine replacement therapy available free to smokers with medical cards would be a step in the right direction.
Incidentally, by reducing the number of smokers, it would lessen the need for Viagra, since smoking is a known cause of male impotence. - Yours, etc., Dr Fenton Howell,
Victoria Terrace, Laytown, Co Meath.