Health professionals can recommend e-cigarettes as tools to help stop smoking, according to new draft guidance from NICE and PHE.
‘The evidence shows that nicotine-containing e-cigarettes can help people stop smoking and are similarly effective to other cessation options such as a combination of short- and long-acting nicotine replacement therapy,’ NICE states.
People should be able to use e-cigarettes as ‘one of several options’ to help quit smoking, said NICE’s expert panel, recommending that they are most likely to be effective in combination with ‘behavioural support’. The draft recommendations stress that people should be advised where to find information on e-cigarettes and that they are ‘substantially less harmful’ than smoking, but that their long-term health effects are unknown.
There are currently no medically licensed e-cigarettes and they are not available on prescription, with their efficacy and safety remaining controversial. While PHE has long maintained that e-cigarettes are around 95 per cent less harmful than smoking tobacco (DDN, September 2015, page 4), and that there is no evidence that they act as a ‘gateway’ to smoking for younger people, WHO’s position is that they are harmful and there is ‘insufficient data to understand the full breadth of their impact on health as devices have not been on the market long enough’.
The NICE committee recommends that further research be carried out into the short- and long-term health effects of e-cigarettes, particularly for groups such as younger people and pregnant women.
According to a survey commissioned by anti-smoking charity ASH, just 12 per cent of smokers were aware that that e-cigarettes were much less harmful than smoking, with a third believing they were ‘more or equally harmful’.
‘This new guidance offers a welcome “how-to guide” for reducing the harm caused by smoking including helping smokers to quit and preventing a new generation of smokers from starting,’ said PHE’s director of drugs, alcohol, tobacco and justice Rosanna O’Connor. ‘This consultation is an important opportunity for all our partners to help shape these recommendations.’
The draft guidelines were a ‘renewed effort to reduce the health burden of smoking and to encourage and support people to give up’, added director of NICE’S Centre for Guidelines, Dr Paul Chrisp. ‘Smoking continues to take a huge toll on the health of the nation and accounts for approximately half the difference in life expectancy between the richest and poorest in society. It is therefore vitally important that we reduce the level of smoking in this country. We need to use every tool in our arsenal to reduce smoking rates, including education, behavioural support, financial incentives, and e-cigarettes if people are interested in using them. Combined, we hope that people who smoke will feel enabled to give up tobacco products once and for all.’
Draft guidelines available for consultation until 6 August at www.nice.org.uk/guidance/indevelopment/gid-ng10086
(Features, August 2023): DDN visited the Global Forum on Nicotine in Warsaw to hear about the challenges of mainstreaming tobacco harm reduction.
(News, August 2023): 40 per cent of smokers in the UK think that vaping is ‘as or more risky’ compared to smoking up from 27% last year.
(Features, February 2023): The genie’s out of the bottle – embracing tobacco harm reduction could end smoking within a generation, says Knowledge Action Change.
Read more articles on tobacco harm reduction, vaping and smoking cessation in the DDN archive.