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Debate about licensing of e-cigarettes as medicines

Thursday January 13th 2022

Respiratory experts have debated if e-cigarettes should be licensed as medicines after the UK announced support for the move.

Writing in today’s edition of The BMJ, Professor Nicholas Hopkinson, professor of respiratory medicine at Imperial College London, welcomes the move.

He argues it will provide doctors with another means to help smokers quit the habit.

He says although e-cigarettes are regulated as consumer products, which means they cannot be promoted as smoking cessation aids, both a Cochrane review and the National Institute for Health and Care Excellence support their use as a smoking cessation aid.

E-cigarettes that have been through a stricter medicinal licensing process “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,” he writes.

Smokers who have been reluctant to try the aids could also be more confident if they become medically licensed e-cigarettes.

However, Professor Jørgen Vestbo, professor of respiratory medicine at the University of Manchester, and colleagues say that the effectiveness of e-cigarettes as a smoking cessation aid is unproven and could be harmful.

Prof Vestbo and his team say evidence from trials show that people using e-cigarettes tend to continue vaping, while those who use medicinal nicotine products stop smoking, and many restart smoking while they continue vaping.

They also argue that the widespread use of e-cigarettes carries a substantial societal risk of accepting addiction and that many of the products are produced and marketed by companies owned by the tobacco industry.

They add that disguising e-cigarettes as a sensible harm reduction strategy “will risk weakening sustainable smoking cessation strategies.”

“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,” concluded Prof Vestbo.

Hopkinson NS, Vestbo J, Bush A et al. Head to Head: Should e-cigarettes be licensed as medicines? BMJ 13 January 2022; doi: 10.1136/bmj.n2912

[abstract]

Tags: Drug & Alcohol Abuse | Respiratory | UK News

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