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An Expert's Perspective

Clive Bates offers clarification through the noise surrounding the announcement that the MHRA has updated its guidance on how vaping products can become licensed for prescription

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Clive Bates offers clarification through the noise surrounding the announcement that the MHRA has updated its guidance on how vaping products can become licensed for prescription. Is it the good news that has been celebrated, or does he think it offers problems of its own?

The Nigerian-based strategist, advocate and communicator currently runs Counterfactual Consulting following a diverse career including working for IBM, being the Director of Action on Smoking and Health (ASH), and being part of Prime Minister Blair’s Strategy Unit.

At the outset, Clive highlights how “the announcement isn’t a change in NHS policy or prescribing practice.

For all of the celebration, this is an important thing to hang on to.

It is a change in the process by which a vaping product can become licensed as a medical product via the UK medicines regulator, the MHRA. This is streamlining to make it more likely that eligible products will become available to add to the formulary for physicians who want to prescribe them, though it doesn’t make this automatic.”

The pathway to a full licence has not been used successfully. To date, only British American Tobacco has made a couple of applications to cover its Voke device – and that never was never followed through. Some experts have voiced warnings that the cost of the application will continue to deter independent companies from applying.

Clive comments that this isn’t the only issue. He recounts anecdotes from companies who have been encouraged down the authorisation path only to find “dogmatic resistance at the working level, as assessors insist on pointless and counterproductive requirements like precisely metered dosing”.

Clive believes the new guidance is geared towards ironing out this imbalance between policy and practice.

He says that even a successful application will not guarantee GP’s being able to prescribe vapes. National Institute for Health and Care Excellence will then have to assess if the product offers value for money. If a product reaches this stage, prescription will still depend on GP’s having the available resources and belief to begin handing products out to patients.

So, does he think that vaping on prescription is a good idea?

No.

Nicotine is a recreational stimulant and the cost should be covered by the user, who will make large savings if they switch from smoking.”

But also yes.

I can see a case for supporting behaviour change (not the sustained behaviour), especially in low income or other disadvantaged smokers for whom the attempt to switch looks like a costly gamble. It also greatly strengthens the role of the provider as a catalyst for change. It could be a good way of reaching into hard-to-reach populations.”

Ultimately, he says, this is a good announcement because it demonstrates strong support from the Government for vaping as a tobacco harm reduction tool and may help to develop new approaches for targeting support to low-income and other disadvantaged groups.

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Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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