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GPs braced for requests for e-cigarettes on prescription as licence is granted

GPs could face thousands of requests from patients wanting to be prescribed e-cigarettes after the Government announced one of the devices has now been granted a licence by the UK drugs regulator.

The Department of Health (DH) confirmed that the newly licenced e-cigarette would be ‘prescribed alongside existing nicotine replacement therapies’.

Public health chiefs said they welcomed the news which they said would provide another ‘option for stop smoking services, GPs and pharmacists to help smokers quit’.

But GP leaders warned it would place an extra, unnecessary burden on GPs and that stop smoking services should pick up the extra demand.

Public health minister Jane Ellison MP revealed the licence had been granted for an E-cigarette during questions in the Commons at the end of November.

Ms Ellison said: ‘The first e-cigarette was licenced by the Medicines and Healthcare products Regulatory Agency earlier this month’.

The Government believes that vaping/using e-cigarettes is ’significantly less harmful than smoking tobacco products’ and that ‘evidence suggests that smokers can substantially benefit their health by fully substituting the use of e-cigarettes for smoking’.

The MHRA confirmed to Pulse that the device was the first ‘true’ e-cigarette to be licensed and that it would be available as a ‘general sales’ medicine for people to buy from pharmacies without a prescription, as well as on prescription through smoking cessation services.

It said in a statement: ‘We have recently licensed the e-Voke as a medicine, which means it is a product of acceptable quality and can be an effective aid to smoking cessation.

‘The e-Voke is the second product meeting the definition of an e-cigarette to receive a marketing authorisation, but is the first product that electronically produces a vapour containing nicotine for inhalation, and thus would be considered a true e-cigarette.’

The DH said in a statement it ‘welcomed the arrival of licensed products that can be prescribed alongside existing nicotine replacement therapies’.

Professor Kevin Fenton, director of health and wellbeing at Public Health England, said evidence indicated e-cigarettes ‘can help smokers to quit, particularly when combined with additional support from local stop smoking services’ .

He added: ‘In addition to other existing nicotine replacement therapies – such as patches, gums and sprays – medicinally licensed e-cigarettes will provide another prescribing option for stop smoking services, GPs and pharmacists to help smokers quit.’

However, Dr John Grenville, secretary of Derbyshire LMC, said busy GPs would be resistant to prescribing e-cigarettes.

Dr Grenville said: ‘Given the mood at the moment, GPs would probably resist prescribing it. I suspect there will be a demand and I think we will look very carefully at how to curb that demand.’

Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee said there was ‘no reason whatsoever for GPs in England to be inundated with this work’.

Dr Green said: ‘Smoking cessation is now part of public health administered through local authorities, who ought to have their own arrangements for the provision of these medications.

‘GPs’ role should now be limited to encouraging smokers to attend these services.’

Readers' comments (24)

  • Is there anyone, anyone at all, in this government with the slightest common sense?

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  • Peter Swinyard

    As an ex-smoker, I look with gentle amazement at all the things people use to help them to quit this highly addictive habit. A quick read of the side effect profile of Champix should put people off (taste disturbance, abnormal dreams, appetite changes, dizziness, drowsiness, dry mouth, GI disturbance, headache, sleep disorders - all common or very common - and take a minute to read the less common s/e in the BNF). Really, it is possible just to decide to stop smoking and then to do so. There is no danger to the body (unlike stopping from very high alcohol levels). Why should the NHS pick up the tab for these scripts? If people can afford to smoke, by and large they can afford the nicotine replacement. And how long to continue?
    We have to have a reality check about what the NHS can afford on its drug budget and on our time and effort in prescribing.

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  • absolutely no way I'm prescribing these. once word gets around you'll be inundated and every appointment will be e-cig requests.

    also do no harm comes to mind. even if safer than cigarettes, I refuse to prescribe something which can directly harm patients and the public.

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  • Oh the thousands of appointments that will be taken up with those wanting free fags. What a calamity!

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  • i refuse to prescribe these too.

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  • Another straw to break the camels back.

    Dear Cardigans,

    Please stop busting a gut trying to save the NHS. Let it go. Let it collapse. It is not viable anymore. Your mental and physical health is collapsing. Your family does not know who you are anymore. Your partner is getting it on with the neighbour. Your kids have ADHD. The drinks cabinet is empty. Your patients do not respect you and your staff is looking for a way out. The government is crapping on you from a hight on a daily basis for years and paying you less and less for the pleasure.
    You are an idiot save-a-ho type of person.

    Get out before you have a stroke.

    Best Wishes

    20/20 vision

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  • Vinci Ho

    The thing is this should go through Public Health but the hypocrisy is their budget will be cut substantially by Ozzy. So GPs are the scapegoats again ....

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  • Well, just refuse. its what im going to do - as Dr Swinyard has mentioned - if they can afford to pay for fags, then they can afford to pay for e-cigs. Not on prescription, not by me.

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  • Please, just for once, could we all not just say NO.

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  • No, No, No No, NO, No, No No No, NO there's no limit...

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  • If gps are now being used like a shop, can they charge a handling fee too for every prescription for eciggies written? Indeed if eciggies are viewed as pharmaceuticals perhaps we should be charging the government a handling fee for every prescription written too as this is a separate service?

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  • They will just send them abroad. I lost it. It broke. Blah blah. Let pharmacists police it.

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  • Can I, cough cough, av me zopis, prgabs and fag..I mean e-cigs while i'm ere plz.

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  • For goodnss sake just write out a prescription how hard can it get

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  • @Practice Manager 2.31

    I'm sure that pharmacists would be delighted to do that. It's not like the flu jab situation, after all

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  • Anonymous | Other healthcare professional08 Dec 2015 4:58pm

    If I was selfish and immoral, and short-termist, yes. If I was sensible, moral, ethical, no

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  • Public health took over smoking cessation from us.
    They can take over the provision of these devices also.

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  • No (in terms of safety) and especially no (on principle) when basic health care is being rationed due to underfunding. Please let me just practice medicine.

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  • I am sure that people would never get them for free then sell them on the black market for a profit. Would they come out of the prescribing budget?

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  • I must say I'm quite shocked by the responses here - these comments would be unsurprising from the outraged Little Englanders of the Daily Fail but in a GP mag?

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  • Business is business and vested interests override common sense. Wonder who got the payback and which Company's products have been cleared by the Drug Regulator. We will soon find out as surely, the e-cigs cleared for sale are not the ones coming from China.

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  • American of course...

    Evoke Smoke are a brand new American based e-cigarette company, looking to make a splash in the ever growing e-cig market. Evoke sell an interesting mix of products we haven’t seen before, so we were excited to give their products a try.

    These one of a kind products include: e-cigarillos, e-cloves, e-blacks, e-cigars and e-cigarettes.

    Evoke has teamed up with e-liquid maker Big Bang, to ensure some great tasting products.
    Big Bang is another start up - American too

    Big Bang Vape Shop · Shop. Select Page. Shop. Sandy Springs. 8610 Roswell Rd #540. Atlanta, GA (770) 552-0020. John's Creek. 10305 Medlock Bridge ...

    Pretty certain they gone through all the necessary clinical trials and are a safe substitute which one can smoke forever. My patients have have been on e-cigs for more than two years now and they love it - and now it's a freebie too funded by the taxpayer. Maybe government will find an American booze maker topo

    Evoke offer free shipping on orders over $60 and a 30 day money back guarantee.

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  • I don't see anything "shocking" (pharmacist @11.06) - robust and realistic in my opinion

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  • In response to Peter Swinyard: nicotine is a profound physiological addiction resulting from a major adaptation in nicotine receptors in the brain. Albeit the physiological changes are NOT the same in everyone (just like some people can abuse alcohol and seemingly get away with it while others can't) the fact remains that nicotine is very highly addictive (probably more than amphetamine) so very few people who have smoked 20+ fags for any significant period can quite "cold turkey". As for Champix- lets talk about relative risk. Smoking vs. Champix? If you were faced with that choice what would you advise your patients?

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