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Up in smoke

At The Pharmacy Show, healthcare commentator and journalist Roy Lilley is chairing the big debate “Should pharmacies sell electronic cigarettes?” on Monday, 6 October 2014. Ahead of the debate, Roy pens his thoughts on the issue.

It’s Herbert’s fault. In 1963, a Korean war veteran, a 40-a-day smoker; Herbert A Gilbert from Beaver Falls, Pennsylvania, filed a patent for a product he described as a “smokeless non-tobacco cigarette”.

Are they or aren’t they? Do they or don’t they? E-cigarettes are they a good thing or bad? Cancerous or not? From what I can see you might as well flip a coin.

According to the University College London: “For every million smokers who switch to e-cigarettes, more than 6,000 lives a year could be saved”. Really? University College London is alleged to have £750,000 tied up in tobacco investments? Mmm.

A Department of Health spokes-bod said:

“More and more people are using e-cigarettes and we want to make sure they are properly regulated so we can be sure of their safety. We have already set out our intention to change the law to ban the sale… to children under 18.

“The UK has an existing licensing system for higher strength products and those that claim to help people quit. We are also bringing in new EU rules to cover lower strength products which will ban most advertising, limit nicotine levels and set standards for ingredients, labelling and packaging.”

Well, that’s OK then.

Maybe it’s worth pointing out that conventional smoking kills 100,000 people in the UK every year.

E-fags? Inhaling stuff that god never put in fresh air can’t be a good idea, can it? I consider myself extremely fortunate that tobacco has never played any part in my life and I have no idea how difficult it is to give up smoking. If smokers knew how they smell and how irritating it is when they ‘pop-out’ for a fag, they might try a bit harder. Who knows?

It’s emerged Boots have been working with Imperial Tobacco to sell e-fags. Other chemist shops will follow, no doubt. Donchyathink pharmacies, selling e-fags gives them a veneer of respectability? Boots, lending their brand, wraps the fags in a cloak of semi-medical decency. “It’s OK to smoke these… I got them from the chemist.” Not good methinks.

If pharmacies sell these things, why don’t they go the whole hog and sell Marlboro on the grounds that a craving for nicotine is a medical condition and they are providing a customer service… like a Nurofen for a hangover… why not a hair of the dog… sell Vodka?

E-fags will hamper the growth of smoking cessation products and services. Why go through the pain of giving up when an electric puff of harmless propylene glycol, vegetable glycerin, nicotine and flavourings will do the trick. Patches and gum are generally lower margin products than the very profitable e-fags; a market worth £193m, that increased by 340% last year. There’s loads of money in this.

Boots say; “… customers wishing to buy the product will have to have a discussion with a pharmacist to ensure they are sold appropriately.” I guess that means in exchange for money.

Pharmacists have long been the Cinderella of the health family. Begging to be allowed to contribute more; med’s reviews, LTC management and the like. They’ve never been taken seriously. Stuck in the canyon between the condoms and suncream they earn a good living without the palaver.

They could recruit and run teams of community nurses and win AQP contracts to manage diabetes and COPD, leg ulcers and the like. But they never do. You just see the occasional head bobbing up and down behind the shelves in the dispensary. Flogging plastic fags doesn’t fill me with optimism about their intent and purpose.

Let’s face it; the future of pharmacy is online. Amazon-style, next day delivery of your prescription to your office or home. Cut the cost of the high street out of the supply chain equation. It’s bound to happen.

Boots? There’s nothing you can buy in Boots you can’t buy elsewhere. It has a confusing retail offering. I’m never sure why I am in Boots, or why it exists. It is owned by a private equity company and locates its HQ outside UK tax jurisdiction in Switzerland. There have been protests outside their stores. Flogging Mickey Mouse Marlboro won’t endear them to their detractors.

I may be wrong but my guess is, if Boots persist with e-fags and other pharmacists follow them, they’ll all see their reputations go up in smoke.

Roy Lilley

Roy Lilley will host the big debate on e-cigarettes at the Pharmacy Show on 6 October 2014. Panellists include: Professor Rob Darracott, Chief Executive, Pharmacy Voice; Michael Clapper, CEO, Vapestick; Dr James Quekett, GP and Educational Lead, Doctors.net; Dr Anthony Cox, Lecturer, Clinical Pharmacy, University of Birmingham; Deborah Arnott, Chief Executive, Action on Smoking & Health; Martin Dockrell, Tobacco Control Programme Lead, Public Health England.

Citation: The Pharmaceutical Journal URI: 20066456

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