Licensing e-cigarettes: opportunities and risks

As the UK announces support for medical licensing of e-cigarettes, experts debate the issue in a recent published article in the British Medical Journal.

“One of many tools”

Nicholas Hopkinson at Imperial College London welcomes the UK’s Medicines and Healthcare Products Regulatory Agency proposal, saying that this “should provide further reassurance to healthcare professionals that they can help their patients to quit smoking in this way, particularly in mental health settings where smoking rates remain high.”

There are still more than six million daily smokers in the UK. E-cigarettes are currently regulated as consumer products, meaning that they cannot be promoted as smoking cessation aids. In addition to provide patients and health care professionals with another means to break dependence on smoking, the introduction of e-cigarettes (that have been through a stricter medicinal licensing process) is likely to improve confidence among smokers who so far have been reluctant to try alternative nicotine products, Hopkinson writes. He concludes that medical licensing of e-cigarettes could help many of the smokers to live longer, healthier lives.

“No professional endorsement”

Jørgen Vestbo and colleagues at the University of Manchester, on the other hand, argues that the effectiveness of e-cigarettes as a smoking cessation aid is unproven and that harms are likely. According to the authors, there is a risk that disguising e-cigarettes as a reasonable harm reduction strategy will weaken sustainable smoking cessation strategies. Furthermore, they stress that a widespread use of e-cigarettes carries a substantial societal risk of accepting addiction. “Instead, doctors should help to revive a decent NHS funded smoking cessation service, lobby politicians to increase taxes on products containing nicotine, and restrict smoking – as well as vaping – even more”, they conclude.