E-Cigarettes on Prescription!
It has been claimed that ‘The English tobacco control/smoking cessation community is internationally regarded as being utterly, hopelessly smitten with e-cigarettes. It’s become almost cult-like.’
Now it seems this community is about to take leave of its senses.
A certain Martin Dockrell, the Tobacco Control Programme Lead of Public Health England, is quoted (Daily Mail, 23 May 2019) as saying
Vaping offers some of the most effective help for smokers to quit smoking…All we need for an e-cigarette to be available on prescription is for one to be licensed as a medicine.
Mr Dockrell evidently hasn’t thought this through.
Because of an ill-judged decision in their youth to take up smoking and thereby become nicotine addicts, smokers are now in the unfortunate position of finding themselves unable to quit. This view is encouraged by the Tobacco Controllers who put about the idea that unassisted quitting is terribly difficult, and that the way to deal with it is to continue to put nicotine into your body but in a different, allegedly safer, way—likely for the rest of your life.
Which will be the favoured e-cigarette?
So if an e-cigarette—Mr Dockrell doesn’t say which one he favours—were to be licensed as a medicine, then it should be available on prescription!
How can an e-cigarette—a nicotine delivery device—be a medicine? Nicotine has no recognised place in the treatment or prevention of any disease, unless one stretches the idea of disease to include smoking.
But smoking is manifestly not a disease in the ordinary sense of the word; it is a voluntary activity, although the urge to smoke may be difficult to resist.
Nonetheless, if for the sake of argument we allow that smoking is a disease, which e-cigarette would Mr Dockrell think should be licensed as a medicine to treat it? At this point his courage fails him: he draws back, and leaves it to others, if there are any, to licence merely one e-cigarette as a medicine.
There are thousands of brands, countless flavours, and many different models of e-cigarettes available. A casual glance at any e-cig website will show these are presented in their myriad variety as lifestyle products. Should only one be licensed as a medicine? Or some? Or all of them? And by what criteria?
Consider a smoker, desirous of quitting, who switches to e-cigarettes. Up to now he’s had to pay for cigarettes or e-cigarettes out of his own pocket. But if we take up Mr Dockrell’s crack-pot idea, the National Health Service will be footing the bill. There are at present over three million vapers in the UK, 40 per cent of whom have allegedly taken to this unnatural activity because they are trying, i.e., failing, to give up smoking. (This is according to the BBC, so it must be true.)
But why should only those who use e-cigarettes to quit smoking have them on prescription? What about all the regular vapers who have completely switched, so they say, from smoking to this new-fangled way of getting their nicotine fixes? Perhaps this is what Mr Dockrell has in mind: if you smoke you’ll have to pay for it yourself, but if you vape, the great British National Health Service will pay for your e-cigs!
E-cigs have 82% failure rate for quitting smoking
How effective are e-cigarettes as a smoking-cessation aid anyway? A paper in the prestigious New England Journal of Medicine in January 2019 concluded that, although e-cigarettes can almost double the rate of abstinence at one year compared with so-called nicotine replacement therapy, e-cigarettes have an 82 per cent failure rate.
What about smokers being encouraged and shown how to stop poisoning themselves with tobacco smoke without continuing to suck nicotine-laden vapour into their lungs for the rest of their lives?
Vape shops now open in hospitals!
This is a picture of a vape shop which was recently opened at one of two hospitals operated by Sandwell and West Birmingham Hospitals NHS Trust in the UK. It’s not as if e-cigarettes are being sold in the usual hospital shop selling toiletries and snacks, which would be bad enough. These are dedicated vape shops operating on NHS premises, selling products bearing a prominent warning label: This product contains nicotine which is a highly addictive substance.
Note the huge poster shouting, ‘Vaping is 95% safer than smoking’. This has almost become a mantra and is regarded by some vaping enthusiasts as if it’s carved in stone. However, if we go to the original paper from which this figure is derived, we find it has some important qualifications:
Our understanding of the potential hazards associated with using electronic nicotine delivery systems (e-cigarettes) is at a very early stage…A limitation of this study is the lack of hard evidence for the harms of most products on most of the criteria.
But if Mr Dockrell has his way, e-cigarettes will be available on prescription!
Text© Gabriel Symonds