PHE Misses the Mark

Following on from the “Evidence Update” in September 2015, Public Health England has done it again. In fact, they have gone as far as repeating the same mistakes as last time, by mentioning the word “prescription”, and/or “NHS” in the press release.

Via the BBC:

E-cigarettes should be available on prescription, according to Public Health England (PHE).

The agency wants them to be prescribed on the NHS within the next few years because of how successful they have been in helping people give up smoking.

Erm, no. As I’ve said before, e-cigarettes are a consumer-driven innovation, not a medicine. I am no fan of a medicalised e-cigarette, never have been and never will be. It’s almost as if PHE have no clue why e-cigs have been so popular and successful, isn’t it?

As Puddlecote rightly points out:

People who have stopped smoking by switching to e-cigs have done so precisely because they don’t have to attend a clinic and drink weak tea with some dreary stop smoking adviser. They use e-cigs because they made their own decision, spent their own money, and chose their own device.

Exactly right. Yes, the variety of both device and liquid options can be overwhelming, but the variety exists for a bloody good reason doncha think? Vaping exists thanks in large part to the first commercially viable device from Hon Lik, and the problem with PHE sticking their oversized snouts into a consumer product is that they’ll end up driving folks away from the products in their drive to make them cessation products.

No e-cigarettes are currently licensed in the UK as a quit-smoking aid.

And PHE is calling for “an easier route” for manufacturers to get a medicinal licence.

“Anything that the [Medicines and Healthcare products Regulatory Agency] MHRA can do to make it easier for manufacturers we think would be helpful,” said PHE health improvement director John Newton.

Well no, there isn’t. BAT withdrew the eVoke because it was shite, in any case, why would manufacturers want to make a medicinally approved device? What’s in it for them? Considering that, as it stands, the only entities capable of getting anywhere close to the requirements are the tobacco companies. Smaller manufacturers (relatively speaking) like Aspire or Innokin, simply do not have the financial backing for it.

It gets worse. Via The Telegraph:

Hospitals have been told to start selling e-cigarettes and letting patients vape indoors – and even in bed – under controversial new health advice.

Public Health England (PHE) said every smoker struggling to quit, including pregnant women, should be encouraged to take up e-cigarettes.

Considering that hospitals are being told, by PHE to stop selling sugary drinks and snacks, they’ll be less inclined to sell e-cigarettes as many of them are including e-cigs in the “Smoke-Free Hospital” shenanigans.

But they called on NHS hospitals to lead the way in “making it easy” for vapers to find somewhere to enjoy e-cigarettes within their buildings, while enforcing a total ban on smoking anywhere on hospital grounds.

Martin Dockrell, PHE tobacco control lead, said hospitals should consider setting aside single occupancy rooms for vapers.

Why? Would you offer single occupancy rooms for smokers? Of course, you bloody wouldn’t! The simple fact of offering vapers preferential treatment is blatant coercion – “here, you can still enjoy nicotine by vaping!” who the hell made you judge, jury and executioner eh?

“Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know.

“It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.”

Well, whose bloody fault is it that the public has such a poor perception of vaping? It couldn’t be the rise of terrible press releases copied ad-infinitum about “cancer-causing chemicals” and “gateway to smoking” could it?

The thing is PHE, you had a grand opportunity to reveal to the public any number of your report highlights, instead, you took the opportunity to spin the NHS/prescription angle. You bungled it. Again.

As for you ASH, you can fuck off too.

ASH supports PHE’s recommendation that smokers who have struggled to quit should try vaping as an alternative to smoking, and that e-cigarettes should be made available on prescription.

These people just don’t get it, do they?

3 thoughts on “PHE Misses the Mark

  1. i can only reiterate the comment I left on facebook regarding this issue ” i dont see a problem with doctors being able to prescribe e-cigarettes made by big pharma to patients as long as you can still buy vape equipment & e-liquid from companies like smok, kangertech and such. smokers could just as well start off with prescription vapes and move on later to the independants if they choose to as anything else. this might be just the push some smokers need to make the switch. this also might make a lot of people who are against vaping change their attitude. here in the UK vapes are already being sold by asda’s supermarket from the dispensing chemist counter and there may well be other dispensing chemist that are selling vape gear, if you bear this in mind its not such a great leap to have doctors prescribe vapes.”

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    • The pharmaceutical industry has zero interest in producing a viable e-cigarette, or even a close replica. That leaves the independent sector; the Smok, Kangertech and Aspire of the world, who will go as far as complying with consumer regulations as that is where their market focus is. The only other player is, of course, the tobacco industry. BAT managed to get a license for the eVoke, which they never pushed to market. JTI, PMI and Altria haven’t even bothered to do that. Nor, I think will they ever bother.

      Medicines authorisation is a costly business, and only a product with an MA can be prescribed in the UK. The better way, as I have touched on previously, is for GPs to support the use of consumer e-cigs for those wanting to give up smoking (or even to just try something different). Have Stop Smoking Services partner with a local vape store to offer starter kits if the individual wants to move away from smoking that way.

      As public health will tell you, quitting smoking with behavioural support is the most effective way, there’s no reason why SSS can’t partner with a vape store to offer an entry-level device, coupled with the behavioural support. Sadly, with the consumer avenue; and thanks to the Tobacco Products Directive, e-liquid strengths will be limited to sub 20mg/ml. The only way to avoid that limit is via med-regs. Which no-one, other than BAT, has bothered with.

      The other factor is of course cost. But as I – and many others have said elsewhere, if you can buy a pack of smokes every day or every other day, you can afford a starter kit.

      Finally, smokers aren’t sick. They do not need medicine to “cure” them. A medicalised e-cig will be dull and boring. A consumer e-cig isn’t dull and boring. It is fun, geeky and maybe a little steampunky. It works because it *isn’t* a medicine. Take the fun away, and it won’t work.

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