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The tide is turning in favour of e-cigarettes

I recently attended the E-cigarette Summit at the Royal Society in London on 13 November 2014, which aimed to offer the opportunity for debate around the use of e-cigarettes. I am a locum pharmacist and stop smoking adviser, and in my role I come across many patients who are smokers.

For smokers, the use of e-cigarettes is one way to help improve their health because licensed products, such as nicotine replacement therapy (NRT), may not always work for them. And we know it is better for smokers to switch to e-cigarettes than smoke.

A panel of experts — including Peter Hajek, professor of clinical psychology, Barts and The London Queen Mary’s School of Medicine and Dentistry, University of London, and Robert West, professor of health psychology, University College London — told attendees that all smokers will benefit by switching to vaping and passive smokers will benefit, too.

International researchers — who worked with David Nutt of Imperial College London — also reported for Public Health England a stark contrast in harm reduction between cigarettes and e-cigarettes.

During the summit, attendees were told how e-cigarette use is actively shown in clinical trials and in practice to help smokers quit smoking. Professor West said that if e-cigarettes were undermining people’s desire to quit, there would be fewer people quitting. But the opposite applies. Quit rates are higher and quit success is higher now than at any time since the smoking ban. He said e-cigarettes certainly give the same quit rates as NRT with health professional support, possibly more.

West said the Smoking Toolkit study showed that, since 2012, there has been a major increase in the use of e-cigarettes to quit and, since 2013, their use has become favoured over NRT. Around 30% of quit attempts involve the use of e-cigarettes, making them the most popular method of stopping smoking.

What we know from experience in the NHS stop smoking services — and this was discussed at the summit — is that dual users (i.e. those still smoking but also using e-cigarettes) are found to have been likely to have tried to quit in the recent past and are more likely to quit in the future, because every quit attempt increases the chance of quitting for good.

Leicester Stop Smoking Service manager Louise Ross expounded the virtues of being broad-minded with regard to e-cigarette use in one session. In the past year, they have started recommending e-cigarettes to patients and the difference since they started doing so has been a 20% increase in quit rates, which they attributed to the rise in e-cigarette use reported by their clients.

Also, research presented by Cancer Research UK and Action on Smoking and Health (ASH) gave positive views about the use of e-cigarettes as a smoking cessation aid.

It is time for those in the profession opposed to e-cigarettes to come around in light of growing evidence. Attending this summit has led me to believe that e-cigarettes should be sold and promoted in pharmacies. Vaping is not smoking.


M Cunningham

Horsham, West Sussex 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20067239

Readers' comments (3)

  • I am a consumer who quit smoking with E-Cigarettes, successfully. For 4 years, at first a dual user, I did not really know I was going to be able to quit, at first. As the products have improved and provide more personal choice for flavor and delivery method, that was paramount to my finally quitting after 43 years of smoking. I would like to add, that as a consumer and someone that has had accessibility, availability and affordability in obtaining E-Cigarettes, anything that would not allow this is a stumbling block for other smokers for us and potential users of E-Cigarettes, those still smoking. I am not sure what your recommendation means, that pharmacies should sell them? There are thousands of small businesses worldwide in the UK and the USA that will be destroyed along with the consumer's access if they are over-regulated. We have found our own exodus from smoking, we are proud of ourselves and each other and in no way should our own creations and product placement be up ended. Thank you I did very much appreciate your professional opinion it is refreshing as compared to so many others that carte blanche are opposed to our miracle, E-Cigarettes.

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  • Lisa, I am genuinely thrilled to have your comment. In your case, years of hardened smoking has been overcome with e-cigarettes, and this is entirely achievable for many other smokers who never thought in a million years that they would become successful quitters. I am also delighted that you highlighted the benefits of having a choice of flavour, and the improvements in e-cigarettes with the newer delivery methods (for example e-liquids and better devices).

    Yes, my view is that e-cigarettes should be sold in pharmacies, because of their proven harm-reduction.

    My view is in line with another speaker at the E-Cigarette Summit, David Sweanor, Professor of Law at University of Ottawa who said “If you have a high degree of certainty of information about a risk, you have a legal and moral obligation to tell people about it”. That is why I don’t want to remain silent or conservative about a health intervention which can, as it has for you, literally, have the potential to avoid risks of serious disease and death at an untimely age, for those who continue to smoke.

    It would be a huge shame if over-regulation stalled this immense Public Health opportunity. True, the evidence is still growing, however in the meantime, there is more than enough proof that e-cigarettes are safe for us to recommend to smokers to help them cut down and or quit.

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  • I don' disagree with anything Margaret said in her letter and subsequent comment. However I do strong;y believe that we have to address the issue of how we avoid creating yet more nicotine addicts if sales are a free for all.

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