Hello and welcome to the November issue of the Journal of Prescribing Practice (JPrP). You may have been aware of the recent news of the Medicines and Healthcare products Regulatory Agency (MHRA) publishing guidance supporting bringing e-cigarettes to market as licensed therapies (Gov.uk, 2021). This guidance was published following a consultation with the E-Cigarette Experts Working Group, a group from across the UK that provides independent oversight and advice to the MHRA.
The Office of National Statistics (ONS) states that in 2019 (the most recently collected data), 14.1% of people ages 18 years and above smoked cigarettes in the UK (ONS, 2020). While at first glance this might not seem excessive, it does equate to around 6.9 million people, an alarming number considering all the knowledge and resources that are now freely available. I'm sure for some of you meeting those who want to quit smoking or are struggling to do so is a common concern within your day-to-day practice, using treatments such as varenicline, bupropion and nicotine replacement therapy (such as patches and gum) (NHS, 2018). With this proposed licensing of e-cigarettes for use in helping smokers stop using cigarettes, practitioners could have a new avenue to explore if patients are reluctant to take a prescription drug or use patches and/or gum. Our sister journal, Practice Nursing, recently published a piece looking at new approaches to helping smokers, detailing how while they work in a similar way to nicotine replacement therapy, they deliver the nicotine in a more pleasant way (Ross, 2021). It's the tar and carbon monoxide that causes many smoking-related illnesses that are seen in smokers; nicotine being the least harmful (Ross, 2021).
At the time of writing, the NICE guidance NG92 is being replaced, along with a number of other tobacco-related NICE guidance documents, by a new overarching set of guidelines. This draft of Tobacco: preventing uptake, promoting quitting and treating dependence is out for consultation and should be published towards the end of 2021.
So, how will this news be viewed by the general public? I'm not sure. While there are clear benefits, as stated on various news sites reporting on this update, such as BBC News (BBC News, 2021), there are several other factors that will come into play, one simply being personal preference. Lifelong smokers who have swayed to and from wanting to quit may be unlikely to move to a more modern form of smoking, and while e-cigarettes would provide the necessary nicotine replacement therapy, the practicality for some might come into question.
Overall though, I think this news is promising. It is estimated that about a 3.6 million people use e-cigarettes, most of whom are ex-smokers, and there is clear evidence, as stated in the Department of Health and Social Care Tobacco Control Plan (2018), that these products do provide positive health benefits for them compared with regular cigarettes. I'm sure you, just like myself, will continue to watch this news develop, and I myself hope this plan will come to fruition in the near future.