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Guideline of the month – e-cigarettes evidence update



The guideline

A Public Health England report, written by UK psychiatrists, which reviews the evidence surrounding e-cigarettes. It explains the risks and benefits to public health, and provides recommendations for policy and practice.

Key points for GPs

• Pending manufacturers applying for a medicinal licence through the MHRA, the authors concluded that medicinally regulated e-cigarettes should be made available to smokers on NHS prescription. They have the potential to help smokers quit, and carry a fraction of the risk of cigarettes.

• Smokers who have failed to quit using other methods could be encouraged to try e-cigarettes. Local stop-smoking services should engage with smokers who want to quit with e-cigarettes.

• GPs should consider recommending e-cigarettes to smokers from deprived groups, where smoking is common, as they offer a potentially wide-reaching, low-cost intervention.

• Smokers who can’t or won’t quit could be encouraged to switch to e-cigarettes.

Practical issues

• There have been concerns raised over e-cigarettes containing flavourings, and more data may be needed on the long-term effects of these products.

Expert comment

Dr Alun George, GP and substance misuse lead in Leeds, said: ‘Using e-cigarettes as an aid to quitting appears logical and I would cautiously welcome this is as a potential treatment. [But]Robust small trials to measure success rates and optimal lengths of treatment would be needed before national rollout.’

Professor Paul Aveyard, GP and professor of behavioural medicine at the University of Oxford, said: ‘This is a very sensible report. It recognises half the population wrongly believe e-cigarettes are as dangerous as tobacco cigarettes. It is important that GPs encourage people worried about the risks of smoking to switch wholly or partially to e-cigarettes. The report recognises that e-cigarettes are popular and supporting greater use is likely to lead to more people stopping smoking.’

The guideline

McNeill A, Brose LS, Calder R et al. E-cigarettes: an evidence update. A report commissioned by Public Health England. London: PHE; Aug 2015