If you’re trying to quit smoking, instead of a stick of nicotine gum or an adhesive square to slap on your upper arm, your doctor could soon hand you an e-cigarette. England could be the first country in the world to allow prescription e-cigarettes, following an announcement on October 29 that the UK Medicines and Healthcare Products Regulatory Agency, the United Kingdom’s medicines regulator, is now inviting manufacturers to submit products for approval.
If an e-cigarette device passes the steps required for licensing, doctors will be able to prescribe it to patients who want to quit smoking. E-cigarettes are thought to outperform traditional smoking cessation aids for a number of reasons: They are more effective at alleviating tobacco withdrawal symptoms (grouchy mood, intense cravings to smoke, poor concentration), users can tailor the device to receive specific nicotine doses, and it gives smokers the sensation of smoking, in that they can hold something between their fingers and take a drag—all without the deadly smoke and tar that cigarettes deliver. And providing a medically licensed e-cigarette on prescription could tackle the barriers that put smokers off from trying them, such as cost or safety concerns. “Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background,” said Sajid Javid, the UK’s health and social care secretary, in the news release.
Smoking still reigns supreme as a leading cause of preventable death in the UK and the US. Every year, more than 8 million people globally die prematurely due to tobacco use, meaning we lose the equivalent of the population of Switzerland annually to a preventable death. “There’s been a global pandemic that’s now more than half a century old, which kills vastly more people than Covid. Nobody’s really treating it anymore as an emergency,” says Vaughan Rees, director of the Center for Global Tobacco Control at Harvard University. Efforts to depopularize smoking have been eclipsed by population growth, meaning that the number of smokers is now at an all-time high, at 1.1 billion. Without support to stop, only 4 percent of smokers quit for good.
But prescriptions will only go ahead if an e-cigarette product designed for smoking cessation proves to be commercially viable to manufacture and sell, which has yet to happen. Manufacturers have been able to submit devices to the MHRA for approval for years but haven’t, “probably because they would struggle to provide sufficient evidence of effectiveness,” says Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine.
Although a contentious issue, the research does suggest that e-cigarettes are an effective tool to quit smoking. A randomized trial in The New England Journal of Medicine found that e-cigarettes do help people quit, and were more effective than traditional smoking cessation aids, such as patches and gum. The latest Cochrane review concluded that nicotine e-cigarettes probably do help people to stop smoking for at least six months, and they probably work better than nicotine replacement therapy and nicotine-free e-cigarettes.
The announcement is yet another hint that the tide may be turning on the demonization of e-cigarettes. On October 12, the Food and Drug Administration in the United States announced that, for the first time ever, it was authorizing a tobacco-flavored e-cigarette from the company Vuse to be sold in the US as an alternative for smokers who want to quit cigarettes. “The FDA determined that the potential benefit to smokers who switch completely or significantly reduce their cigarette use, would outweigh the risk to youth,” the agency’s statement read. But the FDA did not authorize other flavored Vuse products for smoking cessation, including the fruity variants that teens tend to have a penchant for.