UK’s National Health Service Paves Way for Vaping Prescriptions
A Beacon of Hope
England could be the first country in the world to prescribe e-cigarettes medicinally to help reduce smoking rates. As reported in guidelines released on the Health and Social Care Portal of UK.gov website, medical regulators will work with manufacturers to fully assess the safety and efficacy of their products.
This should come as no surprise to anyone who has compared the UK’s science-based approach to smoking cessation with the nicotine abstinence or nicotine replacement therapy options championed by medical authorities in the United States. Uttering a word about cessation or harm reduction in conjunction with a vaping product in the US will get you in a lot of hot water with regulators.
Public Health England, an executive agency in the UK’s Department of Health and Social Care, views vaping as being 95 percent less harmful than cigarettes. They may know what they are talking about. The UK has outperformed EU countries in smoking cessation.
Public Health England has long argued that countless lives could be saved if other countries were willing to follow their and treat e-cigarettes as a form of harm reduction.
The ability to prescribe e-cigarettes is a gamechanger. Marginalized and underserved groups, who are far more likely to smoke than the wealthy, will be able to access tax subsidized cigarette alternatives.
National Health Service
The National Health Service (NHS) is paid for by taxpayer dollars and has proven quick to discard health modalities that prove ineffectual or overpriced. They are a conservative institution, not prone to embracing unusual treatments for the sake of generating headlines.
The NHS refuses to cover chiropractic medicine, naturopathy, herbal medicine, homeopathy, and most health supplements. Despite the protestations of such wealthy luminaries as Prince Charles, these natural medicine treatments have been barred from coverage for several years.
On the flip side of the coin, the NHS has long hosted the “Using E-Cigarettes to Stop Smoking” resource page. The NHS is not a for profit institution. They have skin in the game and their goal is to identify the most effective and affordable treatment options for citizens of the United Kingdom. They would jettison e-cigarettes in a minute if they thought that they were not effective.
The guidance for e-cigarette manufacturers is currently being finalized but the basic details have been announced. Vaping manufacturers will submit their products through the same regulatory channel, the Medicines and Healthcare products Regulatory Agency (MHRA), as any other medicine or device available through prescription by the NHS.
If a product were to be approved, clinicians would then have the option of prescribing an e-cigarette to a patient to help them quit smoking. According to the UK.gov press release, “E-cigarettes contain nicotine and are not risk free, but expert reviews from the UK and US have been clear that the regulated e-cigarettes are less harmful than smoking. A medicinally licensed e-cigarette would have to pass even more rigorous safety checks.”
In 2020, e-cigarettes were the most popular smoking cessation method in England. The NHS reports that, “E-cigarettes have been shown to be highly effective in supporting those trying to quit, with 27.2% of smokers using them compared with 18.2% using nicotine replacement therapy products such as patches and gum.” The highest rates of success smoking cessation, up to 68 percent, are among vapers who work with local Stop Smoking services offered by the NHS.
Vaping Crushes Nicotine Replacement Therapy
The impetus for the decision to allow prescriptions for e-cigarettes can be traced to a February 2019 New England Journal of Medicine study. This study, facilitated through the Stop Smoking offices of NHS, found that vaping was twice as effective as nicotine replacement therapy (NRT) for smoking cessation. The patch and nicotine gum are two popular examples of NRT. NRT products are manufactured by pharmaceutical companies, use synthetic nicotine and are available over the counter in the US.
Billions have been poured into the development of NRT over the last three decades. Despite this investment, a very basic cartomizer loaded with freebase nicotine e-liquid proved twice as effective. The response by the NHS and Public Health England to this study was the only rational one: incorporate e-cigarettes into a comprehensive harm reduction and smoking cessation program. This is exactly the direction that was adopted.
Shifting Goal Posts
The United States has taken a quite different approach. The study was greeted with pearl clutching. The fact that far more smokers quit using e-cigarettes was ignored. That the much smaller percentage of NRT patients who successfully quit smoking were more likely to be totally abstinent from nicotine was touted as proof vaping didn’t work. The lives of those who would otherwise still smoking combustible cigarettes dismissed entirely.
This response to an unwanted result marked a major shift of the goalposts by the anti-vaping lobby. The old myth was that e-cigarettes merely supplemented cigarettes and were a gateway drug to smoking.
This ridiculous theory had been dunked on and debunked a dozen times before the NEJM study. But after the NEJM study, anti-vapers could not in good faith continue to make the gateway drug argument. Instead, total nicotine abstinence became the only acceptable outcome.
Dig beneath the headlines and you will find that even former FDA chief Scott Gottlieb has stated that it would be a net positive if all current smokers switched to vaping.
As he explained in an FDA press release, “While it’s the addiction to nicotine that keeps people smoking, it’s primarily the combustion, which releases thousands of harmful constituents into the body at dangerous levels, that kills people.”
This level of nuance has long since departed the vaping debate in the United States, replaced by some $160 million dollars in Michael Bloomberg lobbying money.
Thanks to the strict PACT Act, marginalized smokers who fail achieve the puritanical gold standard of total nicotine abstinence are once again being funneled back onto combustible cigarettes or e-cigarettes manufactured by Big Tobacco and sold at gas stations.
Kure Vapes will continue to work to provide adult vapers with their preferred e-liquid flavors and vaping devices through our brick-and-mortar locations and regional carriers.
The odds of the US following the lead of the UK seem incredibly remote, but the science is on our side. At the end of the day, that must count for something.