FEATURE
The current position on
e-cigarettes in the UK
Medical licensing, mental health, long-term
use and advertising. Four key UK organisations
outline the current position on e-cigarettes.
By Róisín Delaney
One year on from the implementation
of the Tobacco Products Directive,
evidence continues to be presented to
establish and update the current position
on e-cigarettes in the UK.
In April, a panel included Rob Morrison,
Senior Regulatory Policy Executive at
the Advertising Standards Authority
(ASA), Professor Gillian Leng from the
National Institute for Health and Care
Excellence (NICE), Professor John
Newton of Public Health England (PHE)
and Dr Ian Hudson, Chief Executive of
the Medicines and Healthcare products
Regulatory Agency (MHRA).
These four representatives gave their
organisation’s current and updated
stance on e-cigarettes for smoking
cessation, but also on regulation.
Following this panel’s discussion,
pharmacy minister Steve Brine later
told the committee that he wouldn’t
be against promoting e-cigarettes on
cigarette packs.
Public Health England
Professor Newton told the committee
that PHE’s approach has been to
maximise the potential for e-cigarettes
and drive down smoking, while managing
any risks with appropriate regulations.
“We are very pleased to see a general
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consensus around the view that the use
of e-cigarettes is likely to be substantially
less harmful than smoking.”
However, the professor alluded to
some concerns PHE currently has –
misperceptions and a possible plateau
in the number of smokers transitioning to
e-cigarettes. He told the inquiry,
“At the moment, we are concerned about
the misperceptions about relative harm
among the public. We are also somewhat
concerned that the uptake of e-cigarettes
seems to have plateaued among
smokers.”
On the ever-topical Australian stance
on vaping, the PHE director said
having previously presented facts to an
Australian committee, he couldn’t explain
why different countries reacted differently
to the same evidence.
“The Australian situation was different.
They had lower smoking rates to begin
with when e-cigarettes first appeared. The
feeling there was that they could continue
to control and drive down smoking
prevalence without using e-cigarettes.”
As we now know, the outcome of a recent
year-long public health inquiry Down
Under was mixed, with indications of
support growing in the nation for vaping
as a means to quit cigarette smoking.
When asked whether he felt the UK is
in the best position on e-cigarettes, the
professor said, “I feel confident. The
scale of the harm from tobacco is so
great, with 79,000 premature deaths a
year caused by smoking, that, if there is
a good chance that more smokers will
quit if they are encouraged to use an
e-cigarette than would otherwise quit …
one should remove barriers to smokers
using e-cigarettes to quit.”
The policies on e-cigarettes within
mental health trusts was another line of
questioning put forward by committee
chairs. There is no coherent policy
across mental health trusts on the use of
e-cigarettes to help service users to stop
smoking. This is despite smoking being
the single biggest cause of inequality of
life expectancy for people with severe
mental health conditions, as pointed out
by committee chair Norman Lamb.
The PHE director said, “We would like
any smoker who finds themselves in an
NHS trust to have an opportunity to quit
using e-cigarettes, if that is what they are
choosing to use.” He also referenced the
National Centre for Smoking Cessation
and Training’s publication, which was
designed to provide guidance to such
trusts on e-cigarettes and has been
available since April.