Lunchtime debate – should e-cigs be prescribed by NHS?

On 16th September, it’ll be 17 years since I last had a cigarette. I was one of those smokers who never really wanted to give up, who really enjoyed a cigarette. However, my consumption was a bit worrying – at least a pack of 20 a day.

It was pregnancy which forced my hand. From the moment I saw the positive test, I have not had another cigarette. That doesn’t mean that I never want one. Even after all this time, the smell can (especially after a few wines) set off all the old cravings. Giving up just like that was far from easy and I doubt I would ever have managed it if I hadn’t had that overwhelming incentive to do so. I daren’t have even one or I think that road back to a pack a day would be very short.

I had no choice but to just give up without any help other than the daily “I really want a cigarette, talk to me until the craving goes away” phone calls to various people. They were remarkably effective, by the way. In the same circumstances, that would be the same today. I wouldn’t be able to use e-cigarettes. Evidence suggests, however, that they are 95% less harmful than ordinary cigarettes and can help people give up smoking for good.

Public Health England have summarised all the current evidence relating to e-cigarettes in a report published today, which says:

  1. Smokers who have tried other methods of quitting without success could be encouraged to try e-cigarettes (EC) to stop smoking and stop smoking services should support smokers using EC to quit by offering them behavioural support.
  2. Encouraging smokers who cannot or do not want to stop smoking to switch to EC could help reduce smoking related disease, death and health inequalities.
  3. There is no evidence that EC are undermining the long-term decline in cigarette smoking among adults and youth, and may in fact be contributing to it. Despite some experimentation with EC among never smokers, EC are attracting very few people who have never smoked into regular EC use.

What is particularly important to me is the argument that provision of e-cigarettes by the NHS could reduce health inequalities:

Smoking is increasingly concentrated in disadvantaged groups who tend to be more dependent. EC potentially offer a wide reach, low-cost intervention to reduce smoking and improve health in disadvantaged groups.

Some health trusts and prisons have banned the use of EC which may disproportionately affect more disadvantaged smokers.

I’m also interested that the report busts many of the myths surrounding e-cigarettes. There is no evidence to support the idea that people who have never smoked cigarettes are starting to smoke e-cigarettes, nor are young people becoming hooked on them.

All of this means, says Welsh Liberal Democrat Leader Kirsty Williams, that the Labour Government in Wales should step back from its proposal to ban e-cigarettes from public places:

This report completely contradicts all of Labour’s rhetoric on e-cigarettes.

The truth is that Labour want to ban e-cigarettes because it doesn’t like them, rather than basing the decision on evidence – it’s as simple as that. As a liberal, I don’t think it’s the government’s job to go around banning things just because it wants to.  The Welsh Liberal Democrats will continue to take an evidence based approach.

Time and time again we have argued that the use of e-cigarettes can help people quit smoking.  This report supports that argument.

Labour Ministers in Wales need to take heed of the evidence that is stacking up against them and scrap these proposals at once.

So, the question for today is do you think that the NHS should be prescribing e-cigarettes as part of its strategy to reduce smoking? Or do you think that health choices should be up to the individual and the state shouldn’t poke its nose in? Over to you.

* Caron Lindsay is Editor of Liberal Democrat Voice and blogs at Caron's Musings