Vapes On Prescription Call

Posted 19th February 2018 by Dave Cross
A new Public Health England (PHE) evidence review has been published, written by leading experts, providing an update to the PHE’s 2015 vaping review. Among other things, the PHE is calling for electronic cigarettes to be prescribed on the NHS “within the next few years because of how successful they have been in helping people give up smoking.”

The report covers e-cigarette use among young people and adults, public attitudes, the impact on quitting smoking, an update on risks to health and the role of nicotine. It also reviews heated tobacco products.

The main findings of PHE’s evidence review are that:

  • vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits
  • e-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more
  • e-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country
  • many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40% of smokers have not even tried an e-cigarette
  • there is much public misunderstanding about nicotine (less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine)
  • the use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million
  • the evidence does not support the concern that e-cigarettes are a route into smoking among young people (youth smoking rates in the UK continue to decline, regular use is rare and is almost entirely confined to those who have smoked)

Ann McNeil is the lead author of the report and a professor of tobacco addiction at King's College London. She said: "It is of great concern that smokers still had such a poor understanding about what caused the harm from smoking. When people smoke tobacco cigarettes, they inhale a lethal mix of 7,000 smoke constituents, 70 of which are known to cause cancer.”

"The constituents in tobacco smoke that cause the harm are either absent or at much lower levels in e-cigarettes, so we are confident that they are substantially less harmful than cigarette smoking. People smoke for the nicotine, but (contrary to what the vast majority believe) nicotine causes little if any of the harm. The toxic smoke is the culprit and is the overwhelming cause of all the tobacco-related disease and death."

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Professor John Newton, the PHE’s director for health improvement said: “Every minute someone is admitted to hospital from smoking, with around 79,000 deaths a year in England alone. Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know. It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.”

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Professor Dame Parveen Kumar is the chair of the British Medical Association’s board of science. Her comments exemplify just how far vaping has been accepted: “We welcome this independent review by Public Health England on the use of e-cigarettes and their role in helping people stop smoking. It is important that our approach to these devices continues to be underpinned by a robust evidence base. When e-cigarettes first became available in the UK, doctors highlighted a number concerns about the lack of evidence on the impact of their use, the variable quality and safety of e-cigarettes and e-liquids, yet as this review and other research shows there is now a growing body of evidence and widespread consensus that e-cigarettes are substantially safer than smoking.”

“As this review recognises e-cigarettes are the most popular device used in attempts to quit smoking, they have the potential to play an important role in reducing the harms associated with smoking which leads to 79,000 deaths in England alone every year.”

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The acceptance of vaping stretches to the National Pharmacy Association, who’s spokesperson added: “It is now clear that, on the basis of current evidence, e-cigarettes have a legitimate place in smoking cessation, underpinned by professional advice. It is useful to have a range of options in the stop smoking ‘toolkit’ because every person responds differently to treatment and the stop smoking journey is very personal.”

They continued: “The PHE evidence review will help pharmacists provide up-to-date advice to people wishing to use e-cigarettes as part of their quit smoking journey. It will also help pharmacies decide whether or not to stock e-cigarettes for sale. Many more pharmacies will now feel confident to supply these products.”

In explaining how the PHE now believe that vaping should be available on prescription, John Newton continued: “Anything that the [Medicines and Healthcare products Regulatory Agency] MHRA can do to make it easier for manufacturers we think would be helpful. Almost half of smokers have never tried an e-cigarette possibly because they have views about how risky they are which are not founded on the evidence. We really want to get the message out that they really should consider using an e-cigarette because they're a lot better for them than continuing to smoke.”

The PHE call upon NHS Trusts to adopt the following measures:

  • e-cigarettes, alongside nicotine replacement therapies are available for sale in hospital shops
  • vaping policies support smokers to quit and stay smokefree
  • smoking shelters be removed
  • frontline staff take every opportunity to encourage and support patients to quit

PHE’s Martin Dockrell expanded: “You’d want to make it easy for people to find somewhere where they could go and vape. There is no reason why a hospital shouldn’t designate some indoor areas where patients and visitors can vape.”

Freemax

“We are saying no smoking anywhere on the grounds, no smoking in the smoking shelter, that shelter becomes a vaping shelter, you are allowed to vape there. It is really important that you treat smoking differently than vaping.”

“[In an acute hospital] if you have your own room, you are not going to cause any annoyance to anybody else by the vapour, you can safely charge your e-cigarette. That makes perfect sense. It is going for each hospital to make their own policy but yes we would certainly encourage them to make at least some single occupancy rooms where people can vape. Of course smoking it prohibited everywhere.”

Professor Newton continued: “Staff should be allowed access to spaces where they can use e-cigarettes if that’s what they’re trying to do. There are places where smoking is banned but vaping should be allowed around workplaces, but not actually at their desk.”

The full report can be found here: Evidence review of e-cigarettes and heated tobacco products - McNeill A, Brose LS, Calder R, Bauld L & Robson D (2018).


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