Nicotine replacement therapy (NRT) remains at present the only approved pharmacotherapy for smokers in the UK. For a long time, NRT was available on private prescription only. Smoking was not considered a pathological condition, and there were fears of high costs to the NHS ifNRT became an NHS prescription drug. A few years ago, NRT became available over -the-counter, and very recently nicotine chewing gum went on general sale. These moves may well have public health implications. In addition to this, in 1999 the UK government started to support smoking cessation initiatives, including a provision of free NRT for one week for smokes entitled to free prescriptions. Several issues concerning implementation of this policy require clarifIcation. This includes NRT choice and collaboration with pharmaceutical companies, the question of ensuring the NRT supply is contingent on receiving smoking cessation advice and what this advice should involve, and a rationale and fInancial implications of expanding this policy beyond one week for smokers who benefIt from treatment. Overall, NRT now plays an important role in smoking cessation policy in this country.