E-cigarettes could be prescribed on the NHS in world first

As part of the government's ambition to make England smoke-free by 2030, we could become the first country in the world to prescribe medicinally licensed e-cigarettes.

With the government wanting to reduce smoking rates, prescribing e-cigarettes could be a way of helping people stop smoking tobacco products.

What do those in charge think?

The idea is still in its early stages and medical regulators will collaborate with manufacturers to ensure the products are safe and effective. However, Health and Social Care Secretary Sajid Javid welcomes the step forward in the licensing process for manufacturers.

"This country continues to be a global leader on healthcare, whether it's our COVID-19 vaccine rollout saving lives or our innovative public health measures reducing people's risk of serious illness.

"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," he said.

How will it work?

The Medicines and Healthcare products Regulatory Agency (MHRA) is now allowing manufacturers to submit their e-cigarette products for approval. The regulatory approvals for e-cigarettes are the same as for other medicines available on the health service.

Those given the green light could become licensed medical products. However, it will be down to clinicians to decide on a case-by-case basis whether prescribing an e-cigarette would help a tobacco smoker quit.

It remains the case that non-smokers and children are strongly advised against using e-cigarettes.

Will prescribing e-cigarettes actually reduce smoking rates?

Most e-cigarettes contain nicotine and they are not risk free. However, expert reviews from the UK and USA have been clear that the regulated e-cigarettes are less harmful than smoking. A medicinally licensed e-cigarette would have to pass even more rigorous safety checks.

Smoking remains the leading preventable cause of premature death. While rates are at record low levels in the UK, there are still around 6.1 million smokers in England.

E-cigarettes were the most popular aid used by smokers trying to quit in England in 2020. They have been shown to be highly effective in supporting those trying to quit, with 27.2% of smokers using them. In comparison, 18.2% use nicotine replacement therapy products, such as patches and gum.

Some of the highest success rates of those trying to quit smoking are among people using an e-cigarette to kick their addiction. Up to 68% of smokers successfully quit in 2020-2021 if they combined e-cigarettes with expert input from local Stop Smoking services.

Almost 64,000 people died from smoking in England in 2019 and the Office for Health Improvement and Disparities (OHID) is supporting efforts to level up public health and ensure communities across the country have equal health outcomes.

The e-cigarette initiative also hopes to tackle the stark differences in smoking rates across the country. Smoking rates in Blackpool (23.4%) and Kingston upon Hull (22.2%) are poles apart from rates in wealthier areas, such as Richmond upon Thames (8%).

Reducing health disparities - including in smoking rates - and keeping people in better health for longer are good for the individual, families, society, the economy and the NHS. To achieve this overall ambition, the OHID will work collaboratively at national, regional and local levels. They will also work alongside the NHS, academia, the third sector, scientists, researchers and industry.

The government will soon publish a new Tobacco Control Plan which will set out the roadmap for achieving a smoke-free England by 2030.

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