Should electronic cigarettes be authorized as medicines?

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

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

The introduction of e-cigarettes which have undergone a more stringent medical clearance process “should provide further reassurance to medical professionals that they can help their patients quit smoking in this way, especially in mental health settings where smoking rates remain high,” he wrote. .

It is also likely to improve the confidence of smokers who have so far 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 e-cigarettes, as they become available, will be just one of many smoking cessation aids, ideally accompanied by psychological support for behavior change. .

It is also important to ensure that the e-cigarette debate does not distract from other tasks needed 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 raising of 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 live longer and healthier lives, he concludes.

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

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

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

Disguising e-cigarettes as a sensible harm reduction strategy “will risk weakening sustainable smoking cessation strategies,” they argue.

“Instead, doctors should help relaunch a decent NHS-funded smoking cessation service, lobby politicians to raise taxes on nicotine products and restrict smoking even further – as well as vaping. “.


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