PCRS issues guidance on use of e-cigarettes as stop smoking aid

New guidance from PCRS addresses the latest concerns about the safety of e-cigarettes and advises healthcare professionals how to support an estimated 3.2 million patients who use them to stop inhaling burned tobacco.

Current safety fears have arisen from a number of cases of serious lung disease and deaths in the USA linked to the use of e-cigarettes.

The PCRS document explains that in the UK the use of e-cigarettes as an option to help patients quit tobacco smoking is supported by Public Health England (PHE) and the Royal Colleges of Physicians and General Practitioners. 

Also, NICE says that while not risk free, e-cigarettes are far less harmful than smoking. Concerns around e-cigarettes causing the disease known as popcorn lung are not based on evidence and the chemical (diacetyl) thought to be responsible for this disease has been banned from use in e-liquids in Europe. E-cigarettes approved for sale in the UK are regulated by the Tobacco and Related Products Regulations (2016).

In the USA the market is unregulated with liquids often being home made with diluents and active ingredients that are banned in UK products.

The PCRS guidance emphasises that:

• Healthcare professionals should be prepared to help their patients to quit tobacco smoking and should be knowledgeable about e-cigarettes so they can answer questions if asked or be able to direct people to up to date information.
• People currently using an e-cigarette to support a quit attempt, and unwilling to use alternative formulary options, should be supported to continue their quit attempt using their preferred strategy.  They should be informed about alternative licensed medicinal options, their relative safety profiles and supported in the choice they make.
• All individuals using e-cigarettes in a quit attempt should be supported in cutting down the level of nicotine at a rate that still enables them to abstain from smoking tobacco with a view to ultimately stopping nicotine as well.
• The PCRS Guide to Tobacco Dependency contains pragmatic guidance on how healthcare professionals can support individuals stop smoking.  

Noel Baxter, PCRS Policy Lead, says: “At PCRS we know that the confidence of health professionals to follow PHE guidance on supporting the use of E-cigarettes as part of a quit attempt was reduced following the startling reports from the USA over the summer. We continue to appraise ourselves of the facts and emerging evidence and will update our members and watchers if the situation changes. We particularly encourage practising health staff to respond to the MHRA call for details should you be concerned that vaping has caused harm. Regulation and monitoring systems are robust and developing in the UK and we can all contribute to help people who choose to vape to quit to do so in the least harmful way possible.”

PCRS will continue to monitor emerging evidence around the safety of e-cigarettes and update this position statement as necessary.