Government body says vaping can make ‘significant contribution to endgame of tobacco’ and raises concerns about length of licensing process.
Vaping is safer than smoking and could lead to the demise of the traditional cigarette, Public Health England (PHE) has said in the first official recognition that e-cigarettes are less damaging to health than smoking tobacco.
The health body concluded that, on “the best estimate so far”, e-cigarettes are about 95% less harmful than tobacco cigarettes and could one day be dispensed as a licensed medicine in an alternative to anti-smoking products such as patches.
While stressing that e-cigarettes are not free from risk, PHE now believes that e-cigarettes “have the potential to make a significant contribution to the endgame for tobacco”.
The message was backed by the government’s chief medical officer, Dame Sally Davies, who nevertheless cautioned that “there continues to be a lack of evidence on the long-term use of e-cigarettes”. She said they should only be used as a means to help smokers quit.
“I want to see these products coming to the market as licensed medicines. This would provide assurance on the safety, quality and efficacy to consumers who want to use these products as quitting aids, especially in relation to the flavourings used, which is where we know least about any inhalation risks.”
The 111-page review raises concerns about the length and cost of the the government’s licensing process, which is a key part of the revised strategy to cut tobacco use.
No e-cigarettes have yet been licensed, unlike other nicotine-replacement therapies such as gums, lozenges and patches. Pilot schemes in Leicester and the City of London allow stop-smoking specialists to offer free e-cigarette starter kits, but smokers elsewhere cannot be offered e-cigarettes on prescription.
The Medicines and Healthcare Products Regulatory Agency began its work in this area more than two years ago, and manufacturers have complained that it costs them millions to go through the process.
Jane Ellison, the public health minister in England, reminded smokers that the best thing they could do to avoid falling victim to the country’s number one killer was to quit completely.
“Although we recognise the e-cigarettes may help adults to quit, we still want to protect children from the dangers of nicotine, which is why we have made it illegal for under-18s to buy them,” she said.
The review found that almost all of the 2.6 million adults in the UK now thought to be using e-cigarettes are current or former conventional smokers, most using them to help them quit tobacco or to prevent them going back to smoking.
There was no suggestion that the products were a gateway into tobacco smoking, with less than 1% of adults or young people who had never smoked becoming regular cigarette users.
The PHE decision comes after carefully choreographed moves by anti-tobacco campaigners and public health specialists to help move the NHS towards offering better smoking cessation support and to be less negative about e-cigarettes.
Services are being urged to follow those in the north-east of England in offering behavioural support to those wanting to quit tobacco and using e-cigarettes to try to do so.
Smoking kills about 100,000 people a year in the UK, most of those in England where there are thought to be eight million tobacco users. But official figures suggest smoking is now at its lowest prevalence since records started in the 1940s.
Rates are highest in many of the most deprived areas of England, and getting smokers off tobacco is increasingly seen as one of the best ways of reducing health inequalities.
Worryingly for many of those behind the policy change, increasing numbers of people – up to 22%, compared with 8% two years ago – think e-cigarettes are equally or more harmful than tobacco. This is leading some smokers to avoid switching, studies have suggested.