E-cigarettes could become available on the NHS in World first
E-cigarettes could soon be made available on prescription through the NHS following backing from the E-Cigarette Working Group and the Health Secretary, Sajid Javid.
The Medicines and Healthcare products Regulatory Agency (MHRA) has announced that e-cigarette manufacturers can now submit their vape products for the same regulatory approval process as other medicines. If successful, it would mean that England will become the first country in the world to prescribe vape kits as a medically licensed alternative to smoking.
The plan is awaiting approval from the National Institute for Health and Care Excellence (NICE), but if it does go ahead, then it will be up to doctors to decide whether an e-cigarette prescription is appropriate for their patient. Currently, vape devices and e-liquid are regulated as consumer products, and non-smokers and children will still be strongly advised against taking up vaping.
In response to the news, the Health Secretary Sajid Javid said: “Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background.”
What are the benefits of e-cigarette prescriptions?
In 2019, the Office for National Statistics reported that there were around 6.4 million adult smokers in the UK, and we already know that this number has risen during the Covid-19 pandemic. According to the NHS, around 78,000 people in the UK die from smoking related illnesses each year, so it’s hoped that making e-cigarettes available on prescription could dramatically reduce these statistics.
Worryingly, over a third of smokers in the UK wrongly believe that e-cigarettes are equally or more harmful than combustible tobacco. It’s thought that access to medically licensed vape devices could help encourage smokers to make the switch. Whilst it’s recognised that e-cigarettes are not completely risk-free, Public Health England and the UK Government back the fact that e-cigarettes are around 95% safer than smoking
Professor Nick Hopkinson, medical director at Asthma UK and the British Lung Foundation, said: “The development of medicinally licensed e-cigarettes would be a really important step forward, providing patients and healthcare professionals with an additional tool to break dependence on smoking, backed up by the reassurance that comes from a rigorous authorisation process.”
E-cigarettes are currently the most popular quit smoking aid in England, with the number of vapers rising from 3.2 million in 2020 to 3.6 million in 2021. It’s hoped that the option to switch to vaping on prescription will help millions more smokers kick the habit for good.
What are the potential disadvantages of e-cigarette prescriptions?
Concerns have been raised over the fact that taxpayers would be paying for e-cigarette prescriptions. Vape devices are already available on the consumer market and are far cheaper than smoking.
Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London, said: “I have an ambivalent take on this. On the one hand, the initiative provides a positive message that e-cigarettes are much less risky than smoking and help smokers quit. On the other hand, I am not sure that medicinal licensing of e-cigarettes is a good idea as it is likely that only the tobacco industry will be able to face the costs that medicinal licensing entails, and they may only want products that will not endanger their core business.”
He also recognised the fact that switching to vaping works well for many due to the choice and variety currently on offer in vape stores. “Smokers are more likely to benefit from e-cigarettes if they can select flavours, strengths and products that they like, rather than being limited to whatever becomes licensed. It also does not seem necessary for the NHS to pay for something that smokers are happy to buy themselves.”
John Dunne, Director General of the UKVIA, was more positive about the news, saying: “The government deserves huge praise for taking this bold decision to look more closely at the use of vaping when it comes to smoking cessation and for taking an evidence-based, science-led approach rather than the nonsensical anti-vaping, anti-harm reduction stance of some countries.”
He was also optimistic ahead of the new Tobacco Control Plan, due to be published at the end of 2021. “There is still much more to be done to achieve a smoke free society, but today is a good day for public health. I eagerly await the publication of the new Tobacco Control Plan for further positive measures.”
As manufacturers begin to submit their products for approval to the MHRA, it remains to be seen what type of vape product will be selected for prescription. It’s likely that, for ease of use and management, it could be a disposable device or prefilled pod system. It’s also predicted that the first vape product could be licensed within the next 18-24 months, hopefully helping to reverse the impact of increased smoking uptake during the pandemic.
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