Professor Robert West

Robert West is Professor of Health Psychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre, University College London, UK. Professor West is also co-director of the National Centre for Smoking Cessation and Training and is Editor-in-Chief of the journal Addiction. He is co-author of the English National Smoking Cessation Guidelines that provided the blueprint for the UK-wide network of stop-smoking services that are now an established part of the UK National Health Service. His research includes evaluations of methods of helping smokers to stop and population surveys of smoking and smoking cessation patterns.

The medical model of nicotine dependence

Nicotine dependence is currently regarded as a psychiatric disorder in which the sufferer has lost control over his or her nicotine intake (usually from cigarettes). While some may question this ‘medical model’, its acceptance has conferred important benefits. Regarding ti as a medical problem has made sufferers eligible to receive effective help from the health service. It has led to the development of pharmaceutical products that significantly improve their chances of stopping. It has also strengthened the hand of smokers seeking redress from tobacco companies. However, the medical model may also have undesirable effects. It may unreasonably restrict the range of professionals considered to be eligible to help smokers; it may lead to application of diagnostic principles that are not well suited to identifying smokers who may benefit from help; and, simplistically applied, it may discourage large scale interventions which assume a measure of voluntary control over the behaviour. This paper analyses how it is possible to derive the greatest benefit out of the medical model as it applies to nicotine dependence.