The Medicines and Healthcare Products Regulatory Agency (MHRA) has published guidance that will allow NHS England to prescribe medicinally licensed e-cigarette products for tobacco smokers who want to quit traditional smoking and vape instead.
This debate is part of plans by government ministers to cut smoking rates in England and would mean England is the first country in the world that can prescribe medicinally licensed e-cigarettes. The government aims to become smoke-free by 2030 in England and 2034 in Scotland. At present, around 64,000 people die from smoking every year in England and this new announcement was widely welcomed by charities, doctors, medical leaders, and health campaigners.
Medicinally licensed e-cigarettes will have to pass even more rigorous safety checks to be approved. Vape manufacturers can now contact the MHRA and submit their e-cigarette products to go through the same regulatory approvals as all other medicines available on the NHS with a prescription.
Once an e-cigarette passes approval with the MHRA, NHS doctors could then be able to prescribe e-cigarettes to patients to help them quit smoking on a case-by-case basis. E-cigarettes are one of the top things that help people quit smoking and were the most popular aid used to help those trying to quit in England in 2020. The number of e-cigarette users was 3.6 million in England, compared with 6.1 million traditional smokers.
However, there are now concerns that as Big Tobacco firms buy up e-cigarette companies, if their products are approved by MHRA and prescribed on the NHS, the NHS would be subsidising the tobacco industry.
Professor Grigg, chairman of the European Respiratory Society’s Tobacco Control Committee, said, “it’s a complex issue…they [the MHRA] deal with a whole range of companies and will probably have to take equal weight from the tobacco industry in their deliberations, and probably can’t favour one device over another. They’ll deal with whoever submits their products for licensing – and the tobacco industry will be more likely to submit a case for their device to be licensed. There’s no way the NHS can subsidise the tobacco industry, but the way this process works may mean it’s inevitable that this will happen.”
Many other industry experts have expressed their fears that the regulatory hurdles required for an e-cigarette to be licensed will be massive and that independent e-cigarette manufacturers simply won’t have the resources, money, and staffing to meet these requirements, whereas manufacturers in the tobacco industry will.
Robert West, Professor of Health Psychology at University College London, said, “this could very easily lead to a situation where tobacco company e-cigarettes with limited effectiveness can be prescribed while much better ones cannot. In my view, no healthcare provider should prescribe an e-cigarette produced by a tobacco company”.
The reality is that, at present, there is no definitive proof of what impact the NHS prescribing e-cigarettes to patients will have in the long run. One in three smokers in the UK say that they have never tried a vaping device, so this move could be a great one in that it will move far more people from traditional tobacco smoking to safer e-cigarette devices which are proven to be better for health. We will be observing the situation ourselves to see how things unfold.