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A 'significant minority' of GPs are risking legal action by refusing to prescribe smoking cessation therapies ­ because they do not believe the treatments should be available on the NHS.

Researchers found 26 per cent of GPs turned down requests for bupropion and 8 per cent for nicotine replacement therapy, despite NICE guidance recommending both as first-line treatments.

The decision to refuse treatment was strongly related to the belief that the NHS should not provide smoking cessation therapies, with some GPs believing smokers should pay for treatment themselves while others doubted the drugs' effectiveness.

Study co-author Professor Robert West, director of tobacco studies at the Cancer Research UK Health Behaviour Unit, University College London, said: 'It's like refusing to prescribe antihypertensive medication just because someone is overweight ­ you can't say it's their fault.

'Attitudes have shifted but not everyone has been taken on board.'

He warned 'maverick GPs' might find themselves in

front of the GMC in the near future.

Dr Alex Bobak, a GP in Wandsworth, south-west London, and chair of Smoking Cessation Action in Primary Care, blamed 'out-of-date'

attitudes among a minority of GPs who could be putting themselves at medicolegal risk.

The study of 642 GPs, published in Addiction (November), found GPs had received an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month.

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