E-cigarettes 'should be prescribed on the NHS to cut smoking-related deaths'
Government health officials want to see GPs able to prescribe e-cigarettes on the NHS, they said today as they published a review that said vaping is 95% less harmful than tobacco.
Public Health England (PHE) said much of the public wrongly believes that e-cigarettes carry health risks in the same way cigarettes do, but this is not the case and they want to see smokers taking up the electronic devices to reduce the thousands of people dying from tobacco-related diseases every year.
Health experts said that although GPs and stop smoking services are not able to prescribe or recommend e-cigarettes as none of the products on the market are licensed for medicinal purposes, they hope the MHRA (Medicines & Healthcare products Regulatory Agency) will do so soon.
They said there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers, with almost all the 2.6 million adults using them in Britain either current or ex-smokers, and most of them using the devices to help them quit or stop returning to tobacco.
While it is hard to quantify how many lives could be saved by people switching from cigarettes to e-cigarettes, they said around 80,000 deaths a year in England are caused by smoking - the greatest cause of preventable deaths.
Professor Ann McNeill, of King's College London and an independent author of the review, said e-cigarettes could be a "game changer in public health".
The PHE-commissioned review said smoking amongst both adults and youths continues to decline and e-cigarette use may be contributing to this.
But it said that as the evidence surrounding their safety has grown, distrust of the devices has increased amongst the public.
Professor Peter Hajek, of Queen Mary University London and another independent author of the review, told a briefing in central London that nicotine carries very few health risks and is much less poisonous than previously believed.
He said the main health issues surrounding e-cigarettes concern other ingredients, contaminants and by-products, which can generate some toxicants - but these are at the very low levels found in the air that people generally breathe.
"My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health," he added.
Professor Kevin Fenton, director of health and well-being at PHE, said people who use e-cigarettes to help them to quit smoking would see the best results if this was carried out in conjunction with their local stop smoking services.
"The best thing that a smoker can do is to quit and to quit forever and that there a range of tools which are available to help all smokers quit," he said was the message PHE wanted to get out.
"For some people who may find it difficult to quit using traditional methods, the e-cigarettes may provide a new tool - another tool - for them to switch from smoking which we know is significantly harmful to a method which is significantly less harmful."
He added: "At the moment there are no licensed products that can be used for medicinal purposes and that's one of the reasons why we are very supportive of the MHRA looking at the pathway for ensuring that there are safe and regulated e-cigarettes that can be promoted for medicinal purposes.
"Now once that is approved and when we have products in that pipeline, then absolutely it can be used as part of the tools that we have available to offer to patients to help them to quit."
Prof McNeill said: "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."
Prof Fenton added: "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.
"Local stop smoking services should look to support e-cigarette users in their journey to quitting completely."
Deborah Arnott, chief executive of health charity Ash, said there are still nearly 8 million smokers in England, many of whom would benefit from switching to electronic cigarettes but who may have been put off doing so because of unfounded health concerns.
"This timely statement from Public Health England should reassure health professionals, the media, and the public, particularly smokers, that the evidence is clear: electronic cigarettes are very much less harmful than smoking," she said.
"Quitting completely will always be the best option, and regulation is essential as the market evolves to ensure smokers have access to the safest most effective products, and that uptake by never-smokers remains low.
"However, if every smoker switched overnight to electronic cigarettes many hundreds of thousands of premature deaths would be prevented in the years to come."
But the director of smokers' group Forest, Simon Clark, accused public health campaigners of wanting to control people's behaviour.
"We welcome the report but would question whether prescribing e-cigarettes on the NHS is a justifiable use of taxpayers' money," he added.
"E-cigarettes have the potential to help smokers quit but promoting them as a state-approved smoking cessation aid ignores the fact that many people enjoy vaping in its own right and use e-cigs as a recreational not a medicinal product.
"E-cigarettes have been successful because the consumer, not the state, is in charge."