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Public health staff advised to promote e-cigarettes

NHS public health staff are being advised to welcome e-cigarettes as a potential to help people quit smoking and tackle high smoking rates amongst those with mental health problems, after findings from a Public Health England (PHE) study released today (19 August).

An independent review published by PHE concluded that e-cigarettes are roughly 95% less harmful than tobacco, offering the potential of becoming a medicinally regulated product available in the NHS on prescription.

The review suggested that ‘vaping’ may contribute to decreasing smoking rates among adults and young people, while not acting as a route into smoking for children or non-smokers.

Staff from local stop smoking services are already being instructed to support smokers by presenting e-cigarettes as “another tool for stopping smoking”.

Professor Ann McNeill, one of the leaders in the review, called the devices a “game-changer in public health in particular” as they can reduce the “enormous inequalities caused by smoking”.

There is also an opportunity to use e-cigarettes to help people with mental health problems to quit smoking regular tobacco and keep mental health units smoke-free.

Professor Kevin Fenton, director of health & wellbeing at PHE said: “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. The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting.

“Local stop smoking services should look to support e-cigarette users in their journey to quitting completely.”

Professor Linda Bauld, Cancer Research UK’s expert in cancer prevention, said: “The overall evidence points to e-cigarettes actually helping people to give up smoking tobacco. Free stop smoking services remain the most effective way for people to quit, but we recognise the potential benefits for e-cigarettes in helping large numbers of people move away from tobacco.

“Cancer Research UK is funding more research to deal with the unanswered questions around these products, including the longer-term impact.”

Lisa Surtees, acting director at Fresh (Smoke Free North East), the first region where all local services are actively promoting vaping, said: “Despite making great strides to reduce smoking, tobacco is still our biggest killer. Our region has always kept an open mind towards using electronic cigarettes as we can see the massive potential health benefits from switching.

“All of our local NHS Stop Smoking Services now proactively welcome anyone who wants to use these devices as part of their quit attempt and increase their chance of success.”

The comprehensive review found that almost 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers and are largely using the device to keep from smoking tobacco or quitting altogether.

However, the study also found that growing numbers of people think e-cigarettes are equally or more harmful than smoking – 22% in 2015, up from 8% in 2013. Nearly 23% of people do not know which is safer or less harmful.

Professor John Britton, chair of the Royal College of Physician’s tobacco advisory group, welcomed PHE’s approach to support the use of e-cigarettes for smokers.

He said: “The evidence published today demonstrates that e-cigarettes are not a significant gateway into smoking for a new generation, instead they will help existing generations of smokers to give up, reducing smoking-related harm and saving lives.

“Stop smoking services will now be encouraged to recommend the use of e-cigarettes for people who want to stop smoking but who have not been successful with existing methods – the new evidence shows that behavioural support also increases the chances of success in giving up with e-cigarettes.”

However, Dr Iolo Doull, respiratory expert for the Royal College of Paediatrics and Child Health, warned that it is “vitally important that e-cigarettes do not become a glamorous accessory and act as a catalyst for children wanting to mirror adult behaviours”.

“Whilst we know that they emit fewer toxins, we still do not know what effect they have on health in the long-term,” he said.

But PHE reminded that “appropriate and proportionate” regulation is “essential” to make sure e-cigarettes do not provide a route into smoking for children or non-smokers.

It also encouraged health and social care professionals to provide accurate advice on the risks of smoking and vaping, as well as providing effective routes into NHS stop smoking services.

It added in a press release: “The latest evidence will be considered in the development of the next tobacco control plan for England, with a view to maximising the potential of e-cigarettes as a route out of smoking and minimising the risk of their acting as a route into smoking.”

From October this year it will become an offence to sell e-cigarettes to those under the age of 18.