The timing, one clear week before the opening of COP9, the latest (virtual) gathering of the parties to the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), was interesting and probably no accident. As the famously anti-vaping WHO prepared to talk tobacco – while signally leaving all novel alternatives to play the part of the elephant in the room – the UK Department of Health and Social Care (DHSC) announced that “England could be the first country in the world to prescribe medicinally licensed e-cigarettes to help reduce smoking rates”. Take that, WHO.
England, of course, has long been the world leader in enthusiastic acceptance of vaping. If the country’s (former) health and wellbeing agency Public Health England (PHE) has a claim to world fame it’s as the originator of the now hackneyed (and statistically dubious) assertion that vaping is “95% safer than smoking”. So perhaps we shouldn’t be surprised that the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) is now backing the idea of e-cigarettes on prescription, perhaps delivering stronger nicotine doses than those currently on legal sale.
Don’t expect a free-for-all, though, as England’s smokers flock to the doctor in pursuit of medically approved e-cigs.
It’ll take time
For a start, as Lord Kamall, parliamentary under-secretary for innovation at the DHSC, told the House of Lords, the MHRA “does not feel comfortable licensing any of the existing products”. Which means a wait of at least 18 months to two years before a licensed e-cig hits the pharmacy shelves – even if any manufacturer accepts the government’s invitation to develop one. And that’s just considering the anticipated duration of the licensing process, without taking into account the necessary product development.
And then perhaps we should consider the carefully weighed words of Kamall’s colleague Maggie Throup, who this week told fellow members of the Commons (the lower chamber of Parliament): “Ministers from my department have long been clear…that we support e-cigarettes as part of a gateway process for stopping smoking…Having e-cigarettes as a licensed product will enable them to be available on prescription, which I know will give health professionals greater confidence in their use.”
However: “To achieve a licence, a product would need to meet the standards of quality, safety and efficacy expected of a medicinal product.” (Which will surely put some off – both manufacturers and potential purchasers.)
The ultimate goal
On the up side for vaping: “The evidence is clear that e-cigarettes are less harmful to health than smoking tobacco and are an effective way to help people to stop smoking.” (There are plenty of people around the world, including other politicians and the WHO, who repeatedly say the exact opposite, but this has long been the orthodox British position.)
Of less good news for the long-term prospects of a vaping industry that could in theory put itself out of business by being too successful: “E-cigarettes are just a gateway to stopping smoking completely. That is the ultimate goal. We want to ensure that people go from smoking to e-cigarettes, and then to no smoking at all.” (Here, like so many others, she clearly conflates vaping with smoking, as if you could “smoke” an e-cigarette, but we’ll let that pass.)
And what about that coincidence of timing? “The UK’s approach to e-cigarettes has been and always will be pragmatic and evidence-based. I am sure that will be the message they [the UK delegation] put forward at COP9.”
Except that – as we know, and you’d think Maggie Throup ought to know – the WHO is not intending to allow any discussion of e-cigarettes at COP9 at all.
– Aidan Semmens ECigIntelligence staff