A proposal to subsidise prescriptions for e-cigarettes in an HRT certificate-style scheme has been mooted during a parliamentary inquiry.
Professor Javed Khan, author of the Khan Review, ‘Making Smoking Obsolete’, gave evidence to the Health and Social Care Select Committee (HSCC), as part of an inquiry into preventing ill-health, on Monday.
Professor Khan welcomed the measures recently introduced by the government to make vaping less attractive to children and teenagers, including banning single-use vapes.
But he emphasised the need to ‘strike the right balance’ between the restrictions around vaping and the encouragement to adult smokers using cigarettes to start vaping.
‘Vaping is closer to 95% safer than smoking a cigarette. We should therefore do everything we can to promote vaping as a quit tool, not as something that young people should take up because they think it is a cool thing to do,’ he told the inquiry.
Professor Khan said that he supported the introduction of a ‘medicinally approved vaping approach’ that could be prescribed by GPs, and would help to combat scepticism around vaping from other health professionals.
It is available as inhalators, skin patches, chewing gum, tablets, nasal and mouth spray, oral strips and lozenges, and can be used by most people including children over 12 and pregnant and breastfeeding women.
Although, the government recently announced that vaping alternatives – such as nicotine pouches – will be outlawed for children.
The government also recently introduced a ‘swap to stop’ scheme, which will be rolled out widely over the next two years, with a free vape ‘starter kit’ being offered to one million smokers in England.
‘I met GPs who said that they had never seen any kind of guidance that would encourage them to direct their patients [to vaping]. Pharmacists said exactly the same. They needed clarity,’ he said.
But currently a lack of engagement from industry was holding up this approach, he suggested.
Committee chair Steve Brine MP highlighted the fact that a pack of disposable vapes cost less than a prescription charge in England, unless the person was in receipt of free prescriptions.
‘So, it would have to be accompanied by some form of subsidy to prescription in the way that certain HRT products, for instance, are,’ he suggested.
Professor Khan agreed that such a scheme ‘should be considered’.
But he added that the prevalence of smoking was highest among the least well-off in society.
‘If you're trying to get them off smoking and into vaping then I would have guessed that a large number of them wouldn't have to pay the prescription price,’ he said.
Professor Khan also suggested that vaping sales should be regulated, through a national scheme administered by local authorities.
And he said that funding given to local authorities for smoking cessation should be ringfenced for that purpose.
‘The smoking cessation grant to local authorities sits within the public health grant that they get. The public health grant, since 2016, has gone down by 21%, but in the same period, that element of it that is then passed on to stop smoking services has gone down by 40%,’ he told the inquiry.
Recently the government announced that £70 million a year would be allocated to local authorities in England to support stop smoking services.
The idea of a ‘polluters pay levy’ was also proposed during the inquiry session.
‘We have a very successful £19 billion industry in this country that makes a £10 billion contribution to our taxes but creates a £17 billion cost to society. Surely that industry should take responsibility for the effect that it has,’ Professor Khan told the inquiry.
But committee chair Mr Brine said: ‘That is not where the government is going.’
Professor Khan responded: ‘We live in hope.’