Earlier this year (2021) it was reported that a huge spike had been observed over the course of UK lockdown in the uptake of smoking by young people. Adding to mounting pressure on the UK government to double-down on their smoking cessation efforts, lest their goal of a smoke free generation by 2030 becomes unattainable.
Since that time, we have seen response in-kind, with Labour MP Mary Kelly Foy calling for increased restrictions on the sale of tobacco and intensified warnings for such products. While her propositions are being debated by Commons and Lords alike, a landmark NHS vaping trial has been placing e-cigarettes in the hands of A&E visitors. While the results of the trial are TBC, it is clear that the government is intent on exploring more options when it comes to driving down the number of active UK smokers.
Previously vaping was considered far too great of an unknown to be considered for medical application, however with a growing body of evidence and the NHS’ official trial underway, attitudes have shifted faster than industry experts could have predicted.
As a result, headlines from both the BBC and The Guardian revealed the Medicines and Healthcare Products Regulatory Agency (MHRA) have now sent out a rallying cry to vaping manufacturers across the UK to begin creating and submitting vaping devices for medical registration, with the intent of finally inducting e-cigarettes into nationwide stop smoking services. If achieved, this would make the UK the first country in the world to make such a move.
Vaping Is Seen as The Best Option for Tackling Smoking Rates
Public Health England (PHE) famously reported vaping to be 95% less harmful than smoking as far back as 2015. Despite this a combination of public misconception, bad press from less regulated markets, and reservations from government have preserved the taboo surrounding e-cigarettes and their application as a cessation tool.
A growing body of evidence has since proven consistently that PHE’s original findings, which were grounded in toxicology and scientific research, were a fair and accurate representation of the relative safety of vaping. When combined with multiple studies that also found vaping to be a considerably more popular, and more successful option for people attempting to ditch cigarettes, this latest move by the MHRA is a logical step forward in the battle against smoking.
Chief executive of the MHRA, Dr June Raine, has stressed the evidence is “clear” that vaping poses less risk than smoking tobacco and have been actively seen to help people quit for good. She heralded the MHRA’s updated guidance on licencing requirements as “a strong first step towards the availability of safe and effective licenced e-cigarette products”.
There is a prevailing feeling among experts that vaping could be one of the richest untapped veins in smoking cessation available to roll out currently. Professor Linda Bauld, the Bruce & John Usher Chair in Public Health at the University of Edinburgh pointed out that “While there is good evidence that e-cigarettes available as consumer products can help smokers to quit, we also know that up to one in three smokers in the UK has not tried these devices”.
It is hoped that by introducing e-cigarettes on prescription as an established arm of the NHS’ official stop smoking services, public misconception can be curtailed. At the same time the move would maximise access to vaping as a resource regardless of a person’s social or economic status. It is believed that the relative unknowns around vaping in tandem with its very recent rise to popularity when compared to existing NRT therapies, has become a barrier preventing one of the best options for reducing smoking rates from reaching its full potential.
Professor Bauld has explained that “Smokers have concerns about safety and misperceptions about the relative risks of e-cigarettes compared with tobacco. For some, cost is also perceived as a barrier. The option of having approved devices that could be prescribed would reassure smokers about relative risks and also assist in reaching those least able to afford e-cigarettes.”
The cost-neutralising aspect is of particular importance to those pushing for the change, owing to the significant differences in smoking rates between areas of varying affluence - smoking rates in Blackpool (23.4%) and Kingston upon Hull (22.2%) for example, are vastly higher than rates in wealthier areas such as Richmond upon Thames (8%).
There is Still More Work to Be Done
While the outlook is positive and the MHRA has paved the way for vaping to unlock its potential for doing good in the world, they have explained their reservations at the current offering of devices available to consumers currently.
For those who know the vastly expansive variety of vaping devices already in existence, it may be hard to believe that there isn’t one the MHRA could already endorse to get the prescription service established that much quicker – after all, the clock is ticking down towards 2030 and rapid action is being called for across the board if targets are to be achieved.
The MHRA have stated however, despite the current selection, no device has yet met the required standard for a medical licence. This is precisely why they have now challenged manufacturers to rise to the occasion, and it seems clear that the indirect competition this will cause between suppliers is intended to expedite the process and establish a prescription-worthy vaping product as quickly as possible.
Even with the urgency behind the call to action, regulators are rightly firm in their intent to take as much time as is needed to ensure the general public only get access to a device held to exacting quality and safety standards. It seems likely that 12 to 18 months will elapse before we see any significant breakthroughs, particularly when factoring in the different organisations that will be required beyond the MHRA to make a unified decision on the device and how it will be made available.
The NHS themselves have said that regardless of whether the MHRA approves and medically licences a vaping device, they “will not be prescribing e-cigarettes unless Nice (National Institute for Health and Care Excellence) recommends them for use”.
With that said, time will now tell who will be the first manufacturer to cross the finish line and produce a device that we may one day see as a mainstay of British stop-smoking services. With the door now opened by the MHRA, and with increasing pressure from government and anti-smoking lobbyists, the future of medically approved vaping seems bright.
Visit our Vape Hub to keep up with the latest as the trials and registrations continue!