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Smokers should be encouraged to use e-cigarettes – RCP

E-cigarettes can be safely promoted as an alternative to smoking, the Royal College of Physicians (RCP) has said in a new report.

The report said that e-cigarette use was more likely to lead to more and more successful attempts to quit smoking.

It warned that although there could be a possibility of harm from long term e-cigarette use because of ingredients in the cigarettes other than nicotine, it was likely to be less than 5% of the risks of smoking tobacco.

Professor John Britton, chair of the RCP’s tobacco advisory group, said: “The growing use of electronic cigarettes as a substitute for tobacco smoking has been a topic of great controversy, with much speculation over their potential risks and benefits.

“This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the UK.

“Smokers should be reassured that these products can help them quit all tobacco use forever.”

The RCP report also said that there was no evidence that e-cigarettes encourage or normalise smoking.

At the beginning of this year the Medicines and Healthcare Product Regulatory Agency granted the first licence for an e-cigarette product, the ‘E-voke’ device, to be available on the NHS.

A Department of Health spokesperson backed the initiative, saying: “We want to see a wide range of good quality e-cigarettes on the market including licensed products whose safety, quality and effectiveness are independently assured.”

However, Professor Simon Capewell of the Faculty of Public Health, said: “We don't know enough yet about the long-term effects of vaping on people's health, which is why we need more research.”

He added that there was “solid evidence” that existing NHS quit-smoking services work to help patients quit smoking.

Professor Jane Dacre, president of the RCP, also leant her cautious support to the proposals, saying: “For all the potential risks involved, harm reduction has huge potential to prevent death and disability from tobacco use, and to hasten our progress to a tobacco-free society.

“With careful management and proportionate regulation, harm reduction provides an opportunity to improve the lives of millions of people. It is an opportunity that, with care, we should take.”

The Royal College of GPs has refused to support e-cigarettes yet, and said that NICE needed to do more work on whether prescribing e-cigarettes was worth the cost.

Dr Tim Ballard, the college’s vice-chair of external affairs, said: “Moving forward we would be looking for clear evidence that making e-cigarettes available on prescription as part of a wider smoking cessation scheme is a wise use of both scant NHS funds and GP practice resources, before the College could get behind it.

“It is not just the cost of the product that needs taking into account, but the time and resources that are involved in assessing patients, and monitoring their progress over a prolonged period of time.”

Public Health England have also supported NHS staff promoting e-cigarettes as an alternative to smoking, although researchers from the London School of Hygiene & Tropical Medicine and the University of Liverpool have cast doubt on their findings.

(Image c. Torin Halsey)