The NHS should not prescribe vaping to combat smoking
By allowing the prescription of electronic cigarettes, the NHS would simply be swapping one vice for another, writes Dr Nilesh Parmar.
In a radical move, the NHS may soon prescribe e-cigarettes to smokers trying to quit the habit. If these plans are to go ahead, the United Kingdom will be the only country in the world to approve e-cigarettes for medical usage. Instead of being a bold step towards tackling smoking rates, this could result in many more individuals becoming addicted to nicotine.
The Medicines and Healthcare products Regulatory Agency (the MHRA)'s newly published guidance is based on the argument that smoking e-cigarettes is much healthier than smoking standard cigarettes.
E-cigarettes, just like standard cigarettes, contain high volumes of nicotine. Indeed, due to the ubiquity of vape usage, there are no laws in place to prevent their usage indoors or in social settings – a vaper may even take in more nicotine than a standard smoker.
The health effects of nicotine – and e-cigarettes specifically – are well known and should not be overlooked. Problems with blood pressure regulation, worsened cardiovascular health, and serious lung damage can cause substantial problems for those who vape.
Sadly, this became evident last year as the COVID-19 pandemic struck. Earlier this year, researchers from Imperial College London and King's College London found that smokers were twice as likely to require hospitalisation for COVID than non-smokers. Vapers, though, have not fared much better. Although there has not been much research into its effects, a study last year suggested vaping severely increases younger COVID patients' chance of serious illness, implying the two forms of smoking have similar risks attached.
The pandemic was a startling reminder of the dangers associated with e-cigarettes, but warning signs have been there since before the pandemic.
Despite being a relatively new phenomenon in the UK, problems experienced in the US are a reminder of the danger associated with e-cigarettes. In 2019, there were reported to be over 350 cases of specifically vaping-related lung illnesses in the country. These types of illness could soon become more common in NHS hospitals.
But I must stress, this is a new phenomenon. The dangerous impact of vaping is only beginning to be revealed. The long-term effects are likely to be even more distressing.
In this case, the guidance issued last week by the MHRA will be proven by history to be an unsafe, negligent decision. With resources and funds for our health system already stretched, we must ask ourselves why we are spending money on swapping one addiction for another.
The NHS does not prescribe cigarettes – and rightly so, as it would be a costly, self-defeating policy. Following this logically, if a patient can afford the steep price of cigarettes, they could presumably afford the comparatively cheaper cost of e-cigarettes. Hence, not only is this MHRA guidance an unnecessary promotion of an unhealthy habit, but it also bestows an unneeded cost upon an already underfunded institution.
Rather than funding e-cigarette use, the government should be limiting it. The UK government should follow other countries around the world by banning the sale of fruity and exciting flavours for e-cigarettes, which is certainly linked with a high usage among teenagers.
At the moment, in our unregulated vape market, youngsters are attracted by sweet flavours and are often able to buy e-cigarettes from the shops that so often dominate British high streets. Shockingly, despite the purchase of e-cigarettes being illegal under the age of 18, a study found over 40 per cent of teenagers who vape get their products from such shops. We have a situation currently where those who are not smokers are developing nicotine addictions off the back of vaping. This MHRA decision does nothing to suggest to these youngsters that vaping is a dangerous habit to take up.
This is no way to deal with a public health crisis. Considering the government's commitment to tackling obesity with an array of proposed taxes and health warnings for fatty foods, one would think that – especially after a deadly respiratory illness has swept across the world – it would take the same approach to its citizens' lungs as it does their bellies.
More warnings on packaging, a ban on fruity flavours, limits to nicotine-product advertising, and removing the brands' ability to decorate their products (just as cigarette packets now are standardised and indistinct) would go some way to improving public health. Contrastingly, indulging e-cigarettes by presenting them as a healthy option – as the MHRA is doing – would only worsen the nation's health.
If we really want to help those suffering from cigarette addiction, replacing one vice with another – and further impoverishing the NHS in the process – is the completely wrong way to do it. Yes e-cigarettes can help people quit smoking, but is this something the NHS should be paying for?
