Prescription e-cigs - to attract sceptical smokers

Smokers will be able to get e-cigarettes on prescription. This is the UK government's next step to reduce smoking in the country.
"The possibility of obtaining certain e-cigarettes on prescription can help smokers understand relative risks, but also attract those who cannot otherwise afford to try e-cigarettes" says Linda Bauld, Professor of Public Health.

Vaping has become the most popular aid among smokers trying to quit in England. 30 per cent of those who made a quit attempt in 2020 used e-cigarettes, compared to 20 per cent who used other nicotine replacements. This is according to the UK government in press release. 

"Having a medically licensed e-cigarette available for prescription is a step in the right direction. Any action by the Medicines Agency to make it a realistic possibility is good." says John Britton, a medical doctor and formerly responsible for tobacco issues at the British Medical Association, to Science Media Centre.

Millions of vejpers completely smoke-free

E-cigarettes and e-liquids are now regulated consumer products and doctors have only been able to recommend e-cigarettes to smokers, not prescribe them. 

Statistics from the country's government-funded stop-smoking centres show that nearly seventy percent of clients using e-cigarettes had quit smoking completely between 2020 and 2021. According to the organisation ASH (Action on Smoking and Health), nearly two-thirds of the country's 3.6 million vejpers quit smoking completely. 

Equalising class differences

At the same time, 14% of the population still smokes. And the gap between rich and poor is wide when it comes to smoking. Up to 24% smoke in typical working class areas compared to 8% in more affluent neighbourhoods. The UK government hopes to change this by encouraging companies to apply for medical approval for any of their products. Something that has been possible for a long time, but which no one has chosen to do.

"The ability to prescribe e-cigarettes can open the door to levelling the playing field when it comes to smoking. Britons should have the same opportunities to quit smoking, wherever they live," said the Minister for Social Affairs. Sajid Javid in a press release.

"One in three smokers have not tested"

Among health professionals and researchers in the field of tobacco and harm reduction, the news is being received with mixed feelings. 

"Whilst there is good evidence that e-cigarettes in the form of consumer products can help smokers quit, we also know that one in three smokers in the UK have not even tried an e-cigarette," said Mr Snyder. Linda Bauld, Professor of Public Health at the University of Edinburgh.

Can boost confidence in e-cigarettes

Linda Bauld, a long-time campaigner for making e-cigarettes safer and more accessible to smokers in England, believes that the ability to obtain an e-cigarette on prescription can boost confidence in vejpning as a safe smoking cessation tool.

"Smokers worry about how safe e-cigarettes really are. And there are serious misconceptions about the relative risks of e-cigarettes compared to tobacco... A medically authorised product can act as a guarantee for some. At the same time, even those who don't consider themselves able to afford an e-cigarette will have the chance to try the technology," says Mr Perez. Linda Bauld to CNN.

Not only positive

But the proposal is also being criticised by other health experts. Robert West, a professor of health psychology, as well as Linda Bauld is committed to making e-cigarettes more accessible. And he says that prescription e-cigarettes are not just a positive thing. 

"It has always been possible for e-cigarette manufacturers to apply for medical clearance for their products. However, no one has done so. This is most likely due to the high costs involved," said Mr Perez. Robert West. 

Only tobacco companies that can afford it

Robert West argues that prescription e-cigarettes are more likely to hamper development.

"Smokers already have access to safe and effective e-cigarettes without a prescription. The risk is that only companies with huge assets will succeed in getting a product authorised as a medicine. It is likely that only the big tobacco companies that can withstand such a process. And since the tobacco companies' vejp products are, in general, quite ineffective in smoking cessation, we risk having a situation where mediocre products are approved and the best ones are not." says Robert West to the Science Media Centre.

E-liquid on prescription nothing new

The call from the UK Department of Health could lead to the UK becoming the first country in the world to have a medically tested e-cigarette on the market. In contrast, in several other countries, including Sweden, authorities have tried to get e-liquid with nicotine classified as a medicine, following pressure from pharmaceutical companies. In Australia since October 2021, all nicotine-containing e-liquid is illegal to sell or import without a doctor's prescription.

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