E-cigarettes: proceed with caution

I note that your online poll suggests support for the sale of e-cigarettes in pharmacies (2014;293:412). It is not clear who you polled but that is beside the point.

We need to proceed with extreme caution in this matter. First, let us be absolutely clear about the motivation of many of the companies marketing these products. They would like to develop a whole new generation of nicotine addicts who become lifetime users. Some are actually tobacco companies. They are marketing them as a cool and harmless product to young people, with many tempting flavours. Secondly, let us be clear that the hardest nicotine replacement products to stop using, after you have quit smoking, are those that give you a “hit” like a cigarette. Thirdly, nicotine, apart from being fatal in overdose, is by no means harmless. It affects heart rate and powerfully constricts the peripheral circulation. It is very addictive.

As pharmacists, we should of course aim to help smokers quit. Simply selling another addictive product is not the answer. We should provide smoking cessation services where possible and, of course, supply only products licensed for this purpose.

Brian Curwain

Christchurch, Dorset