Dr Miriam Stoppard believes that the UK could be encouraged to quit smoking by licensing e-cigarette makers. This would give smokers confidence that the e-cigarettes are less harmful.
I once considered quitting smoking while I was a junior doctor. I reckoned I couldn’t help them anywhere near as much as they could help themselves by quitting.
I didn’t of course, but I firmly believe that smoking is so damaging to health we should do anything to stop it.
Then came the e-cigarette.
They’ve always been controversial and they are creating waves once again after an announcement by the UK’s Medicines and Healthcare Products Regulatory Agency that it will look favourably on licence applications from e-cig firms so doctors can prescribe them to patients wanting to kick the habit.
This has made the cat a pigeon.
Opponents are sparring in the pages of the BMJ, with Professor Nicholas S Hopkinson of the National Heart and Lung Institute in the YES corner, and Professor Jørgen Vestbo and colleagues of Manchester University in the NO camp.
Vestbo asserts that only the UK can grant a licence for e-cigarettes to be classified as drugs.
Because of their ineffectiveness, E-cigarettes have not been approved by any major scientific society.
The most well-known trial that compared e-cigarettes to medicinal nicotine products found that e-cigarettes had a superior abstinence rate of 18% compared to 10% for medicinal nicotine.
But, the nicotine group was twice as likely to have stopped smoking as those using e-cigarettes, who tend to vape on, while most people who use medicinal nicotine quit.
The YES camp emphasises that e-cigarette users inhale vapour created by heating liquid containing a humectant to retain moisture, nicotine and flavourings.
E-cigs of course aren’t completely safe but they don’t contain the most toxic component of tobacco smoke – solid tar particulates – nor carbon monoxide.
Users’ exposure to other constituents in e-cigs is far lower than in people who smoke.
The Government’s independent Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment describes the risk of adverse health effects from vaping as “substantially lower”It is better than smoking.
Cochrane’s respected review of e-cigarettes supports them as a way to quit smoking, as does the National Institute for Health and Care Excellence.
Tobacco cigarettes were never subject to regulatory scrutiny.
However, e-cigarettes would be licensed and subject to the same scrutiny as smoking cigarettes. This could increase consumer confidence and correct false beliefs about relative harm.
Remember, the UK’s aim is to be smoke-free by 2030.