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E-cigarettes could be available on NHS prescription to tackle smoking rates

The Medicines and Healthcare products Regulatory Agency (MHRA) has updated its guidance for licensing e-cigarettes – paving the way for these products to be prescribed on the NHS in England and help slash smoking rates.

The MHRA is inviting e-cigarette manufacturers to submit their products for approval to be medically licensed, it said in updated guidance published today (October 29).

Each application should conclude within 150 days and, if approved by the MHRA, clinicians could then decide whether to prescribe the e-cigarette on a “case-by-case basis”.

E-cigarettes were the most popular aid used by smokers trying to quit in England in 2020, the Department of Health and Social Care (DH) said.

They “have been shown to be highly effective in supporting those trying to quit”, the DH added, with 27.2% of smokers using them compared with 18.2% using nicotine replacement therapy products such as patches and gum.

While smoking rates are at record low levels in the UK, there are still around 6.1 million smokers in England. Smoking remains the leading preventable cause of premature death, with almost 64,000 deaths from smoking in England in 2019.


Smoking cessation rates “much higher” under pharmacist supervision


The Association of Independent Multiple Pharmacies (AIMp) CEO Leyla Hannbeck told C+D: “It is well documented that smoking [cessation] rates are much higher when under the supervision of a pharmacist and their trained staff.

“People who smoke often have other health conditions and will benefit from being able to walk into a pharmacy without an appointment,” Dr Hannbeck added.

She said: "All e-cigarettes should surely only be permitted either on prescription or as P medicine sales because people who might have underlying health conditions are currently buying these products from various outlets on the high street where they can not have any pertinent medical advice”.

But according to the MHRA guidance published today, “if the licence granted permits the product to be sold and supplied as a General Sales List (GSL) medicine, then the retailer does not need to be a pharmacy. People can buy GSL medicines from retail outlets such as corner shops and supermarkets, as well as pharmacies where they would be available for self-selection".


E-cigarettes help tackle “stark disparities” in smoking rates


Following today’s announcement, Health and Social Care Secretary Sajid Javid said: “Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background.” 

Chief executive of the MHRA Dr June Raine added that the MHRA “will continue” to support and encourage companies in the development of safe e-cigarette products “in order to support patient-centred care and access”.

“The evidence is clear that e-cigarettes are less harmful to health than smoking tobacco and that nicotine-containing e-cigarettes can help people quit smoking for good,” she said.

The government is expected to publish a new Tobacco Control Plan soon, which will set out the roadmap for achieving a smoke-free England by 2030.

In August, the Pharmaceutical Services Negotiating Committee, the DH and NHS England and NHS Improvement also announced that a smoking cessation advanced service will be commissioned from January 2022.

This service will enable “NHS trusts refer patients discharged from hospital to a community pharmacy of their choice to continue their smoking cessation care pathway, including providing medication and behavioural support as required”.


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