Patients often ask my views on e-cigarettes and my response has always been pragmatic, if not necessarily evidence-based: ‘It’s got to be better than smoking’. After all, just about everything is better than smoking, unless, that is, you’re about to light up a stick of dynamite instead.
Well, it would appear I was right all along. Because Public Health England (PHE) has recently published an independent review demonstrating that vaping has fewer risks compared to smoking and is linked to improved quit rates.
So far, so good. But then PHE extrapolates from this to suggest that e-cigarettes should be available on prescription and I find myself screwing up my face in disgust, like I do when someone has just blown a cloud of cigarette smoke into it.
Don’t get me wrong. I want smokers to quit, obviously. It’s just that I’m not convinced that the NHS should be subsidising their attempts, particularly where e-cigarettes are concerned. For one thing, it’s not as if patients are incurring any net expense – they can fund their vaping habit from the money they save not smoking. For another, I really don’t need patients to be given yet another reason for booking an appointment with me. And for yet another, being the dispenser of what in most cases amounts to free vape-vouchers will do nothing to improve my levels of job satisfaction.
True, the precedent has already been set with nicotine replacement therapy (NRT) on prescription, but at least with patches, gum et al there’s a sense of medical direction, with these products generally used in a logical nicotine withdrawal regime. Not so with e-cigarettes. I suspect many are simply happy to swap the old long term habit of smoking for the new long term habit of vaping, which will continue to give the street cool/social edginess so many of them crave almost as much as hits of nicotine.
I’d be more than delighted if pharmacies could be their e-cig suppliers, though. It gives you some income and gives them some medical professional input if they wish. And, most important of all, it weans them off me.