This paper examines the current regulatory obstacles to extending the permi
tted use of NRT, and to include smoking reduction ways of addressing these.
There are major differences between different countries in regulations con
cerning NRT. These differences appear to be due to different attitudes to c
igarette smoking as an issue and different preconceptions about nicotine as
an addictive and potentially toxic drug. The paper considers how existing
WHO and American Psychiatric Association definitions of mental disorders ma
y be used in submitting proposals for use of NRT as an aid to smoking reduc
tion and how concerns over safety and abuse and dependence liability can be
addressed. It also examines what new evidence may be needed. Coordinating
the efforts of the pharmaceutical industry, clinicians and researchers will
probably be important in moving regulatory authorities further in the dire
ction of accepting NRT for widespread use in smoking reduction.