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E-cigarettes to be made available on prescription as review finds them "95% less harmful than tobacco"

Smoking NHS Prescription E-cigarettes

An independent expert review commissioned by Public Health England (PHE) has found that e-cigarettes are "significantly less harmful to health than tobacco" and may be contributing to a fall in the number of tobacco smokers.

2.6 million people are now regularly using an e-cigarette device, the majority of whom are using it to help them cut down or quit using tobacco or have already quit altogether.

The review found that 44.8% of people do not realise that e-cigarettes are significantly less harmful than smoking and identified a marked increase in those who believe that e-cigarettes are equally or even more harmful than smoking - from 8.1% in 2013 to 22.1% in 2015. 22.7% told the ASH Smokefree Survey that they 'didn't know' if e-cigarettes were harmful or not.

E-cigarettes and the practice of 'vaping' has attracted some negative media attention in recent years, possibly due in part to safety concerns regarding some cheaper, unregulated imported versions and reports that children and young people who had previously never smoked tobacco were using them, possibly moving on to tobacco as a result.

'No evidence so far' that vaping encourages tobacco use

However, the experts, led by London-based Professor Ann McNeill of King's College and Professor Peter Hajek from Queen Mary University, carried out a comprehensive review into the use of e-cigarettes and found there was "no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers" - figures for this group were less than 1%.

Professor McNeill says: "There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely. E-cigarettes could be a game changer in public health in particular by reducing the enormous health inequalities caused by smoking."

PHE says that emerging evidence indicates that the highest success rates among those wanting to quit tobacco are seen when e-cigarettes are used alongside support from NHS Stop Smoking Services, where traditionally medication in tablet form is offered alongside Nicotine Replacement Therapies (NRT), such as nicotine patches, nasal sprays and chewing gum, available for the price of prescription to help ease symptoms of tobacco withdrawal. E-cigarettes are not currently provided on prescription as they are not a licensed medicine.

PHE says it is: "committed to ensure that smokers have a range of evidence-based, effective tools to help them to quit.

"We encourage smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of local stop-smoking services, given the potential benefits as quitting aids."

PHE said as a result of the review it is anticipating the arrival on the market of a choice of medicinally regulated products that can be made available through the NHS on prescription.

Dr Ram Moorthy, spokesman for The British Medical Association, who had previously expressed concern regarding the use of e-cigarettes, urged caution. Dr Moorthy told BBC news: "We need to see a stronger regulatory framework that realises any public health benefit they may have, but addresses significant concerns from medical professionals around the inconsistent quality of e-cigarettes, the way they are marketed, and whether they are completely safe and efficient as a way to reduce tobacco harm."

Lisa Surtees, acting director at Fresh Smoke Free North East, the first region where all local stop smoking services are actively promoted as e-cigarette friendly, says: "Our region has always kept an open mind towards using electronic cigarettes as we can see the massive potential health benefits from switching."

Smoking still 'number one killer'

Professor Kevin Fenton, Director of Health and Wellbeing at Public Health England says: "Smoking remains England’s number one killer and the best thing a smoker can do is to quit completely, now and forever. E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm."

Professor Linda Bauld, Cancer Research UK’s expert in cancer prevention, said of the findings: "Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realised based on the evidence assessed by this important independent review. In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco."

"Free Stop Smoking Services remain the most effective way for people to quit but we recognise the potential benefits for e-cigarettes in helping large numbers of people move away from tobacco."Cancer Research UK is funding more research to deal with the unanswered questions around these products including the longer-term impact."

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