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Is vaping just swapping one addiction for another?

Xrayser wonders whether e-cigarettes are that different to the other vices he sees in community pharmacy

It was announced last week that the rates of  smoking in the UK have fallen yet again, as prevalence of cigarette smoking in England dropped from 25% a decade ago to just 18% today. This is also reflected in popular culture: if the image of “cool” in the 1950s was James Dean with a cigarette, Google “cool” today and you get pictures of psychedelic cats – presumably because photos of Brad Pitt with an e-cigarette would just look wrong.

Much of the reduction in smoking is attributed to the uptake of ‘vaping’, a habit described as “95% safer than smoking” – presumably in the same way that methadone is 95% safer than heroin. Personally, I don’t see this as a reduction in smoking, just a change in the manner of drug delivery.

But with the objective of harm minimisation, this over-the-counter shared care is something to be encouraged. However, I must be careful about what I say on this subject, as whenever I’ve previously discussed this on social media, I have been – somewhat ironically – flamed.

At a recent “e-cigarette awareness event”, we were told that we’ll now be paid to support people changing from conventional smoking to vaping. This decision was taken by the council’s public health department. By their logic, a “vaper” should be considered a “quitter”, even though they’re not actually quitting their addiction.

Of course, an e-cig these days looks less like a cigarette and more like a biro rammed into the top of a Jerry can. According to the awareness event, these industrial delivery devices for nicotine are the superior “third-generation” e-cigs, and allow for much greater customisation of power, temperature and flow rate. All very different to the primitive process of igniting paper tubes of the rolled, dried Nicotiana leaf.

When it came to a presentation by a vaper, their fervent love and adoration for all things e-cig at first reminded me of patients we see with addictions to other pharmaceutical substances. But gradually, I wondered how different it was to the excitement, knowledge and specialist equipment of the barista or sommelier – making it illogical when people argue that vaping should be banned from pubs.

And so we come to the question of whether to allow someone to vape in our pharmacy or staff room? We don’t have a problem with the consumption of the produce from coffee machines, although maybe I’d draw the line at a row of optics and a cocktail shaker.

Meanwhile, as we wait for social mores to catch up with this new way to enjoy an old drug, pharmacy is left with challenging quit targets and dwindling smoking cessation income. Maybe this explains why this month is both “Stoptober” and “Go Sober in October”.

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