E-cigarettes as effective as nicotine replacement therapy for smoking cessation, says draft guidance

Draft guidelines on smoking cessation from the National Institute for Health and Care Excellence and Public Health England say evidence indicates that nicotine-containing e-cigarettes can help people stop smoking.
e-cigarette smoking

Healthcare professionals, including pharmacists, should offer advice on e-cigarettes as a strategy for smoking cessation, according to draft guidelines produced by the National Institute for Health and Care Excellence (NICE) and Public Health England.

The draft guidelines, which went out for public consultation on 25 June 2021, state that evidence indicates that nicotine-containing e-cigarettes can help people stop smoking and are similarly effective to other smoking cessation options, such as nicotine replacement therapy (NRT).

It advises that a combination of short- and long-acting NRT or nicotine-containing e-cigarettes, in conjunction with behavioural support, are most likely to result in people successfully stopping smoking.  

To support this, the recommendations state that individuals should be advised on where to find information on nicotine-containing e-cigarettes and how to use them properly. It also says that although e-cigarettes are less harmful than smoking, the long-term health effects are still unknown.

“These draft guideline recommendations are a renewed effort to reduce the health burden of smoking and to encourage and support people to give up smoking,” said Paul Chrisp, director of NICE’s Centre for Guidelines.

“We need to use every tool in our arsenal to reduce smoking rates, including education, behavioural support, financial incentives and e-cigarettes, if people are interested in using them. Combined, we hope that people who smoke will feel enabled to give up tobacco products once and for all.”

The draft guidelines also recommend that, in addition to pharmacological and behavioural support, pregnant women who are referred to a stop-smoking service should be offered vouchers to encourage them to stop smoking. Although, they add, it should be ensured that these vouchers cannot be used to purchase products, such as cigarettes or alcohol, that are harmful in pregnancy.

“It is great to see the expertise of pharmacists in smoking cessation recognised,” said Gino Martini, chief scientist at the Royal Pharmaceutical Society (RPS).

“However, public health funding has cut many of the cessation services previously offered by pharmacies.

“People should be advised of all the smoking cessation options available so that they find the one that’s best for them, and the ultimate aim should be to support people to stop using e-cigarettes and to be free of nicotine addiction altogether.”

Martini added that the RPS advocated the “precautionary principle approach” to minimise exposure to e-cigarette vapour until more safety data becomes available.

Last updated
The Pharmaceutical Journal, PJ, June 2021, Vol 306, No 7950;306(7950)::DOI:10.1211/PJ.2021.1.92931

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