Smokers should pay for e-cigarettes, not the NHS

With NHS resources being stretched to their limits, Dr Nilesh Parmar argues that the health service shouldn't be wasting resources on smoking alternatives, and the burden should fall upon smokers themselves.

As we head into 2022, the NHS is headed for another bleak winter. With waiting lists pilling up, nurse shortages on the wards and the Omicron variant bloating our ICU units, the NHS's resources and staff are, yet again, being stretched to their limits. On top of this mounting pressure, the NHS has recently announced it will be dishing out vaping 'starter packs' to aid people in giving up smoking.

I find it bizarre that instead of increasing nurses wages or creating more ICU units, the NHS has opted to facilitate the nation's nicotine habit. We should be focusing on managing the next wave of COVID; perhaps we should debate the logic of handing out free, addictive e-cigarettes to the nation afterwards.

In the NHS plan, patients who wish to give up smoking will be able to freely access NHS-approved devices.

This move seems startlingly out-of-touch. We cannot stock enough lateral flow tests even when they are needed most. We are also in the middle of a nursing crisis, which has only been made worse by the miserable pay and terrible working conditions. The NHS always struggles with funding. I therefore do not believe that now is the time to distribute e-cigarette devices that can be bought in any corner store.

Of course, smoking is a major public health issue. The NHS states that smoking kills around 78,000 people per year, and is the cause of 7 out of every 10 cases of lung cancer. However, the government itself has recorded a "significant" decline in numbers of smokers; smoking numbers have been declining every year since 2011.

The deluge of anti-smoking campaigns and measures in schools, numerous anti-smoking campaigns on billboards and TV, higher prices, and the new non-branded cigarette packaging introduced in 2016, replacing famous colour schemes with visceral images. With enough health warnings to catch the attention of even the most dedicated smoker.

This has been achieved without the NHS splashing out on free vapes for all. This measure feels like we are fixing our sights on the wrong issue, at the wrong time.

As I have written before, vaping itself is still not without risk. Between the two poisons, use of e-cigarettes is believed to be safer than smoking tobacco products, but it would be better for the NHS to encourage not smoking anything at all. Although a fairly new product, we have already found evidence of carcinogens and other harmful toxins being inhaled through those brightly packaged, strawberry-shortcake flavoured vaping devices.

Indeed, research out of San Francisco has found that vaping increases the chances catching a COVID-19 diagnosis among young people aged 13 to 24 in the US. Considering we are trying to do everything we can to bring numbers down, prescribing a product that could make this figure rise even higher seems beyond ridicule.

There is no doubt that we need to stop people from smoking, but we shouldn't be encouraging more people to vape in its place. It may be sensible to wean people away from tobacco, but e-cigarettes are still packed full of nicotine – one JUUL pod has around the same level of nicotine as an entire pack of cigarettes. Of course, the addiction doesn't end when the pod runs dry.

If people do wish to try e-cigarettes in order to stop smoking tobacco cigarettes, as many thousands have done, then making the substitution is the lesser of two evils. However, it shouldn't be the taxpayers job to make this transition, it should be down to the smokers themselves.

Walk into any shop, and in that mysterious booth behind the checkout is a large selection of tobacco products and e-cigarettes with their liquids. If a smoker can afford to buy a pack of cigarettes from this booth, they could afford to buy a vape too. Indeed, they can purchase the type of vape they actually likely to use.

The NHS already offers a multitude of services for those trying to give up smoking for good, including the "Stop Smoking" service, offering expert advice which is four times more likely to get people to kick the habit for good than when attempting it alone. These are the methods we should keep; those which focus on cutting smoking out entirely.

The figures show they work. Just think how far we've come since people first became fully aware of the dangers of smoking in the cultural tobacco wars of the 1960s.

We shouldn't give up on this battle against nicotine addiction. If you want to substitute one toxic nicotine addiction for another, then it should be the smoker who funds it, not the taxpayer.