NHS ignoring good advice?

Posted 26th February 2015 by Dave Cross
The website ‘Guidelines’ provides concise clinical guideline summaries of major primary and shared care guidelines in the UK. Additionally, European guidelines from some of the major independent professional bodies are also summarised and included.

Guidelines now includes the informative, positive and logical briefing on the treatment of electronic cigarettes from 2014, courtesy of The National Centre for Smoking Cessation and Training (NCTSC).

The NCSCT was established to support the delivery of smoking cessation interventions provided by local stop smoking services, support the NHS and Local Authorities to deliver effective evidence-based tobacco control programmes, and deliver training and assessment programmes to stop smoking practitioners and other health care professionals.

It’s worth highlighting some of the information being given to the NHS that executives and admin officers are choosing to ignore. Reading through the selected points might lead you to wonder why such advice is not being factored in to new policy:

  • The quality of electronic cigarettes is improving.
  • Data from one good quality randomised controlled trial show that electronic cigarettes were as effective as nicotine patches.
  • Short-term exposure to electronic cigarettes appears to be associated with few serious risks.
  • There are no high quality safety data regarding long-term electronic cigarette use but there is no a-priori reason to expect that such use may pose risks anywhere near the risks associated with smoking.
  • Low levels of toxicants and carcinogens have been detected in electronic cigarette liquid and vapour although these are much lower than those found in conventional cigarette smoke and are not considered to pose any passive inhalation risk.
  • Dual use of conventional cigarettes and electronic cigarettes has been associated with greater motivation to quit and to a reduction of smoke intake from regular cigarettes.
  • Dual use of conventional cigarettes and electronic cigarettes may be associated with health benefits, although the extent of any such benefits remains to be determined.
  • There are currently no robust data to support the concern that the existence of electronic cigarettes might ‘normalise’ smoking and increase use of conventional cigarettes.
  • Be open to electronic cigarette use in people keen to try them; especially in those that have tried, but not succeeded, in stopping smoking with the use of licensed stop smoking medicines
  • Electronic cigarettes are not a magic cure, but some people find them helpful for quitting, cutting down their nicotine intake and managing temporary abstinence
  • Electronic cigarette use is not exactly like smoking.
  • Some health risks from electronic cigarette use may yet emerge, these are likely to be, at worst, only a small fraction of the risks of smoking. This is because electronic cigarettes do not contain combustion chemicals, which cause lung and heart disease and cancer.

The full sixteen-page briefing goes on to expand on the key points and cites 82 reference sources.  It features profound statements such as: “No adverse effects of short- term electronic cigarette use has been found on haematological or blood chemistry parameters, nor cardiovascular function in smokers or ex-smokers.”

It poses the rhetorical question: what is it that prevents the NHS from adopting evidence-based tobacco control programmes?

Vape Club

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, motorbikes, and dog walker