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| E-cigarettes could be prescribed by the NHS to help smokers quit, report says | E-cigarettes could be prescribed by the NHS to help smokers quit, report says |
| (35 minutes later) | |
| E-cigarettes are 95% less harmful than tobacco and could be prescribed on the NHS in future to help smokers quit, a review of their use has concluded. | E-cigarettes are 95% less harmful than tobacco and could be prescribed on the NHS in future to help smokers quit, a review of their use has concluded. |
| Experts who have compiled a report for Public Health England say "vaping" could be a "game changer" for persuading people to quit cigarettes. | Experts who have compiled a report for Public Health England say "vaping" could be a "game changer" for persuading people to quit cigarettes. |
| They also say there is no evidence they give children a "gateway" into smoking. | They also say there is no evidence they give children a "gateway" into smoking. |
| Some health campaigners have welcomed the findings, but the British Medical Association has expressed caution. | Some health campaigners have welcomed the findings, but the British Medical Association has expressed caution. |
| The Welsh government has previously announced that it plans to ban the use of e-cigarettes in enclosed spaces. Now opposition parties have criticised the plans. | |
| E-cigarettes are increasingly popular and are now used by 2.6 million adults in Britain. | E-cigarettes are increasingly popular and are now used by 2.6 million adults in Britain. |
| But public health experts have been divided over whether they should be seen as a much safer alternative to smoking, or a pathway to a deadly addiction. | But public health experts have been divided over whether they should be seen as a much safer alternative to smoking, or a pathway to a deadly addiction. |
| Public Health England asked a team of experts to examine the emerging evidence. | Public Health England asked a team of experts to examine the emerging evidence. |
| Their findings are unequivocal. On the question of safety, they conclude - as a broad estimate - that e-cigarettes are "around 95% less harmful" than smoking. | Their findings are unequivocal. On the question of safety, they conclude - as a broad estimate - that e-cigarettes are "around 95% less harmful" than smoking. |
| One of the report authors, Prof Ann McNeill from King's College London, said e-cigarettes could be a "game-changer" in public health. | One of the report authors, Prof Ann McNeill from King's College London, said e-cigarettes could be a "game-changer" in public health. |
| 1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on | 1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on |
| 2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge | 2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge |
| 3. The mixture becomes vapour and is inhaled. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow. | 3. The mixture becomes vapour and is inhaled. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow. |
| Different brands of e-cigarettes contain different chemical concentrations. | Different brands of e-cigarettes contain different chemical concentrations. |
| "At the moment, 80,000 people [in England] die every year as a result of cigarette smoking. If everybody who was smoking switched to e-cigarettes that would reduce to about 4,000 deaths a year. That's the best estimate at the moment. It may well be much, much lower than that." | "At the moment, 80,000 people [in England] die every year as a result of cigarette smoking. If everybody who was smoking switched to e-cigarettes that would reduce to about 4,000 deaths a year. That's the best estimate at the moment. It may well be much, much lower than that." |
| The report says that although GPs and stop-smoking services are currently not able to prescribe e-cigarettes as none of the products on the market are licensed for medicinal purposes, they hope that hurdle will be removed in the future. | The report says that although GPs and stop-smoking services are currently not able to prescribe e-cigarettes as none of the products on the market are licensed for medicinal purposes, they hope that hurdle will be removed in the future. |
| Potential cost | Potential cost |
| By Hugh Pym, BBC health editor | By Hugh Pym, BBC health editor |
| From nowhere to more than 2.5 million British users in under a decade - the e-cigarette story has moved at a dramatic pace | From nowhere to more than 2.5 million British users in under a decade - the e-cigarette story has moved at a dramatic pace |
| But what about the cost of prescribing? | But what about the cost of prescribing? |
| In England in 2013-14, there were nearly 1.8 million prescription items to help patients stop smoking. | In England in 2013-14, there were nearly 1.8 million prescription items to help patients stop smoking. |
| More than half were for Nicotine Replacement Therapy, including patches, gum and sprays. | More than half were for Nicotine Replacement Therapy, including patches, gum and sprays. |
| The cost to the NHS in that year was just under £49m, down on the figure three years earlier. | The cost to the NHS in that year was just under £49m, down on the figure three years earlier. |
| If approved, e-cigarettes would add to that total, with the kit costing £20 or more and replacement fluid about £10-a-week for the average smoker trying to kick the habit. | If approved, e-cigarettes would add to that total, with the kit costing £20 or more and replacement fluid about £10-a-week for the average smoker trying to kick the habit. |
| Health campaigners will argue that the cost is justified by long-term savings on the treatment of smoking related diseases. | Health campaigners will argue that the cost is justified by long-term savings on the treatment of smoking related diseases. |
| Public Health England says it is "committed to ensure that smokers have a range of evidence-based, effective tools to help them to quit. | Public Health England says it is "committed to ensure that smokers have a range of evidence-based, effective tools to help them to quit. |
| "We encourage smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of local stop-smoking services, given the potential benefits as quitting aids," it adds. | "We encourage smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of local stop-smoking services, given the potential benefits as quitting aids," it adds. |
| "PHE looks forward to the arrival on the market of a choice of medicinally regulated products that can be made available to smokers by the NHS on prescription." | "PHE looks forward to the arrival on the market of a choice of medicinally regulated products that can be made available to smokers by the NHS on prescription." |
| In the meantime, Prof McNeill said she would urge health professionals to discuss the use of e-cigarettes with people who want to quit smoking. | In the meantime, Prof McNeill said she would urge health professionals to discuss the use of e-cigarettes with people who want to quit smoking. |
| "If I was running a stop-smoking service, I would encourage people who are interested in trying e-cigarettes to have a go. I would also be recommending all the other evidence-based medications that people can use." | "If I was running a stop-smoking service, I would encourage people who are interested in trying e-cigarettes to have a go. I would also be recommending all the other evidence-based medications that people can use." |
| The review also highlights evidence that growing numbers of people have doubts over the safety of the devices. It says nearly half the population (44.8%) do not realise e-cigarettes are much less harmful than smoking. | The review also highlights evidence that growing numbers of people have doubts over the safety of the devices. It says nearly half the population (44.8%) do not realise e-cigarettes are much less harmful than smoking. |
| Prof Kevin Fenton, director of health and wellbeing at Public Health England, said it was important to tackle what he called "harmful myths". | Prof Kevin Fenton, director of health and wellbeing at Public Health England, said it was important to tackle what he called "harmful myths". |
| "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." | "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." |
| Strong regulation | Strong regulation |
| The report concludes there is no evidence, so far, that e-cigarettes are acting as a route into smoking for children or non-smokers. It says regular use is found "almost exclusively" among those who have already smoked, and that e-cigarettes have rapidly become the most widely used quitting aid in England. | The report concludes there is no evidence, so far, that e-cigarettes are acting as a route into smoking for children or non-smokers. It says regular use is found "almost exclusively" among those who have already smoked, and that e-cigarettes have rapidly become the most widely used quitting aid in England. |
| The findings have been welcomed by Action on Smoking and Health (Ash). The charity's chief executive, Deborah Arnott, said: "This timely statement from Public Health England should reassure health professionals, the media, and the public, particularly smokers, that the evidence is clear: electronic cigarettes are very much less harmful than smoking." | The findings have been welcomed by Action on Smoking and Health (Ash). The charity's chief executive, Deborah Arnott, said: "This timely statement from Public Health England should reassure health professionals, the media, and the public, particularly smokers, that the evidence is clear: electronic cigarettes are very much less harmful than smoking." |
| The British Medical Association, which has backed curbs on the use of e-cigarettes, was more guarded. Spokesman Dr Ram Moorthy said the review would help ensure an informed debate, but he insisted the public needed protection. | The British Medical Association, which has backed curbs on the use of e-cigarettes, was more guarded. Spokesman Dr Ram Moorthy said the review would help ensure an informed debate, but he insisted the public needed protection. |
| "We need to see a stronger regulatory framework that realises any public health benefit they may have, but addresses significant concerns from medical professionals around the inconsistent quality of e-cigarettes, the way they are marketed, and whether they are completely safe and efficient as a way to reduce tobacco harm." | "We need to see a stronger regulatory framework that realises any public health benefit they may have, but addresses significant concerns from medical professionals around the inconsistent quality of e-cigarettes, the way they are marketed, and whether they are completely safe and efficient as a way to reduce tobacco harm." |
| A spokesman for the Welsh Government, which aims to restrict e-cigs in line with cigarettes, said: "We are concerned the use of e-cigarettes may renormalise smoking, especially for a generation who have grown up in a largely smoke-free society. | A spokesman for the Welsh Government, which aims to restrict e-cigs in line with cigarettes, said: "We are concerned the use of e-cigarettes may renormalise smoking, especially for a generation who have grown up in a largely smoke-free society. |
| "We are not alone in our concerns - the World Health Organisation and other international bodies have called for greater regulation of e-cigarettes and 40 other countries have already taken similar steps. | "We are not alone in our concerns - the World Health Organisation and other international bodies have called for greater regulation of e-cigarettes and 40 other countries have already taken similar steps. |
| "Our Bill does not aim to prevent the use of e-cigarettes for those seeking to give up conventional smoking." | "Our Bill does not aim to prevent the use of e-cigarettes for those seeking to give up conventional smoking." |