New draft guidance from the U.K.’s National Institute for Health and Care Excellence (NICE) states that healthcare professionals can recommend e-cigarettes, or vaping devices, as a means to help patients stop smoking. The guidance states that evidence suggests that e-cigarettes have a similar effectiveness to short- and long-acting nicotine replacement therapies (NRT) in helping people to stop smoking.
E-cigarettes or vaping devices are not licensed as medicines, but they are regulated by the Tobacco and Related Products Regulations. Unlike NRT they are not available on prescription, however NICE said that people should be able to use them to help stop smoking if they wanted to do so, according to gponline. It added that combining behavioral support with either NRT or e-cigarettes was more likely to help people successfully stop smoking than vaping or NRT alone.
Patients who do choose to use e-cigarettes to help them quit should be warned that the long-term health impacts of their use is still unknown, NICE said. Patients should also be told where to find advice on how to use them and told to stop smoking completely if they decide to use e-cigarettes.
NICE recommended that further research should be undertaken in this area, including on whether vaping devices could be used in pregnancy.
However, the guidance highlighted that the MHRA was monitoring possible short- and long-term harms of e-cigarette use and, as at March 2020, ‘no major concerns had been identified’. It recommended that healthcare professionals providing stop smoking advice should report any adverse events as a result of e-cigarette use.
The guidance also makes a series of new recommendations to identify and support pregnant women who smoke, including that all pregnant women have routine carbon monoxide testing at antenatal appointments to assess their exposure to tobacco smoke.