I like Iceland. It is a really neat place; great people; terrific scenery; lively nightlife; surprisingly temperate climate, considering the latitude, thanks to the Gulf Stream.

Of course, it is true that some of the Iceland bankers, poorly regulated and without scruples, were even more predatory than many of the American Wall Street investment bankers, taking the money and running to lead a pack of nations into international fiscal calamity, a drama not nearly at an end.

But, I digress.

Iceland guarantees basic medical care to all of its 330,000 people, boasts one solid medical school, and is serious about the health of its people.

It was among the first countries to show that microbial antibiotic resistance could be reversed by cutting back on antibiotic prescriptions for conditions that don’t need them, such as URIs, acute otitis, etc.

Iceland also has established a comprehensive gene database to better understand the role of genetics in health and disease.

So, it may not be surprising that the Iceland government is considering a physician-sponsored legislative proposal that represents a new and vigorous approach to tobacco control.

If passed into law, tobacco cigarettes would be sold only in pharmacies to people over the age of 20 with a permit, and perhaps, by prescription only.

Only 15% of the Iceland population now uses tobacco, although 20% of their youth now smoke.

Radical? Not really, when you consider how many people become addicted to nicotine so quickly, especially as children, and how many of them later die from tobacco-related diseases.

Not aggressively preventing initial nicotine addiction is radical, considering the consequences to individuals and populations.

Tobacco nicotine addiction is best handled by primary prevention. If a person does not experiment with tobacco until adulthood, that person is unlikely to become addicted. Tobacco should be kept out of the hands of teenagers, even for experimentation.

Addiction, once established, does deserve therapy.

Nicotine can be delivered to tobacco addicts who “simply must have it” through a variety of modalities. Using the modality of tobacco smoking does deliver nicotine to treat withdrawal, but also delivers so many other more toxic substances as to render that modality the most harmful.

With this new creative initiative, physicians could decide on what, if any, nicotine delivery system is best for their patients and write the script.

Will this solve the tobacco problem? No.

Black markets for cigarettes; tobacco as a street drug; physicians who run “pill mills” might also run “fag shags.” Morality really can’t be legislated.

But we should hope that Iceland does enact this groundbreaking legislation. And the rest of the world can watch closely for results.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.