Should electronic cigarettes be permitted as medicine?

Nicholas Hopkinson of Imperial College London welcomes the move, saying it will give doctors another way to help smokers quit.

Electronic cigarettes are currently regulated as consumer products and therefore cannot be promoted as smoking cessation aids, he explains. Yet a Cochrane review already supports existing e-cigarettes as a smoking cessation aid, as do the recently updated guidelines from the National Institute for Health and Care Excellence.

The introduction of electronic cigarettes which have gone through a more stringent drug authorization process “should further reassure healthcare professionals that they can help their patients to quit smoking in this way, particularly in mental health facilities where smoking rates remain high, ”he writes. .

It is also likely to improve the confidence of smokers who so far have been reluctant to try this approach, as well as reverse false beliefs about the relative harms of smoking, he adds.

He points out that medically licensed electronic cigarettes, as they become available, will be just one of many tools to support smoking cessation, all ideally provided with psychological support for behavior change.

It is also important to ensure that the debate around e-cigarettes does not distract from other tasks necessary to achieve the UK’s ambition to be smoke-free by 2030, such as the introduction of a tax. “Polluter pays” on the profits of the tobacco industry and the increase in the age of sale. from 18 to 21, he adds.

There are still more than six million people who smoke in the UK: Medical approval of e-cigarettes could help many of them live longer and healthier lives, he concludes.

But Jørgen Vestbo of the University of Manchester and his colleagues say that the effectiveness of e-cigarettes in helping people quit smoking is unproven and potentially harmful.

They point to evidence from trials showing that people using e-cigarettes tend to continue vaping, while most people using medicinal nicotine products stop smoking and many resume smoking while continuing to vape (called ” dual purpose “). The widespread use of electronic cigarettes also carries a substantial societal risk of accepting addiction, they add.

Additionally, many e-cigarettes are produced and marketed by companies that are part of the tobacco industry – an industry that has a habit of lying to the public and spending a fortune on marketing, including to teenagers. “We need to protect the children and teens from these cynical traders and allow them to be the first generation in a century not to be addicted to nicotine,” they write.

Disguising e-cigarettes as a sensible harm reduction strategy “would risk undermining sustainable smoking cessation strategies,” they say.

“Instead, doctors should help revive an NHS-funded smoking cessation service, lobby politicians to increase taxes on nicotine-containing products, and further restrict smoking – as well as vaping – . “


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