Should the NHS give electronic cigarettes on prescription?

Some e-cigarettes will not be regulated and so could have unknown amounts of nicotine or other chemicals. Photograph: Garo/Phanie/Rex

Last week it was recommended by researchers that the NHS could start off prescribing e-cigarettes as a review finds them to be 60% much more efficient than nicotine substitute.

Euan Ferguson, Observer writer

The Observer needs to have a debate about whether the NHS need to prescribe e-cigarettes, and I, an ex-smoker, say no, and you, as a foremost spokesperson for the anti-smoking lobby, believe, potentially, it truly is a yes. Allow me set out my stall. I resented the smoking ban. I championed the right to smoke, and equally the rights of people to be offended by it taking place in their face – mine was a very dwell-and-allow-reside perspective, it is a large planet out there, and I could never fairly recognize the curtain-twitching intolerance on the element of either lobby. But what’s accomplished is carried out. The query now is ought to men and women be aided by the state to quit anything born of their own really human failings, namely an addiction. I feel not, any significantly less so than they need to assume help with gastric bands, or small breasts or willies. E-cigarettes – I curse them, but I have need to have of them – are a fantastic move towards “more healthy” smoking, but, let us encounter it, if you can afford to smoke or have smoked, you can afford to purchase a Ten Motives starter pack – about £14 – and a leading-up of five cartridges (£7) a couple of times a week. I do hope you disagree!

Deborah Arnott, chief executive of Ash

Euan, I do disagree. Smoking prices are highest among the poorest and most disadvantaged in society. Youngsters developing up in properties exactly where their mothers and fathers smoke are 3 occasions as likely to smoke themselves, so this is a disadvantage passed down from generation to generation. Smoking is largely an addiction of childhood, not an grownup decision. Latest study appears to display that smokers are obtaining electronic cigarettes valuable in quitting, much more helpful than nicotine replacement treatment purchased more than the counter, and that is wonderful. Even so, smokers who get medication on prescription and help from the NHS end smoking companies are far far more profitable than if they consider to quit cold turkey or purchase nicotine items in excess of the counter. In addition, electronic cigarettes are at present really lightly regulated so their security and efficacy is not assured. We’d like to see them regulated as medicines to guarantee they are excellent high quality and so they can be manufactured available on prescription. Quitting smoking is vital for good quality and quantity of existence. Long-phrase smoking can shed you a decade or a lot more of life, plus several many years of unpleasant ill overall health beforehand from cancers, heart illness and strokes, often with lungs so destroyed by smoking that you struggle to draw breath for many years just before you die. These are not matters of private taste like the size of your breasts or your willy, but matters of daily life and death.

EF Deborah. With respect, I disagree profoundly with your contention that smoking is largely an addiction of childhood, not an grownup selection. This imposes not only a guilty burden on the mother or father but also a concatenate denial of children’s free of charge will as they mature, which increasingly they are not permitted to do. All the smokers I know started late. Some via an try to increase a personality, others by means of peer-group strain: but every through forgivable stupidity.

I am supremely conscious of the reality that smoking prices are highest among the poorest and most disadvantaged. Wealthy men and women have much more beauty to live for: when you are bad, less so.

A huge element of the difficulty is that for numerous years we have had so many bloody people lecturing us about stopping smoking who, crucially, didn’t, ever, smoke. Gums and patches had been never going to function, fail as they ever did to get into account the good tube-thing, in the fingers: it truly is not just the nicotine addiction, it really is the breaking of habits.

Nicotine is the most addictive of all medication. By rights, Marx ought to have written “religion is the nicotine of the people” and not let opium have a appear-in. So allow us, for now, have our fake cigarettes and our nicofix – but, rather please, allow us shell out for it. We’re utilized to it, inured to it, and will not want to even more upset the horses.

DA This is not an “either/or” alternative. Electronic cigarettes would nevertheless be accessible on common sale for smokers and ex-smokers like you to get. All I am arguing is that they should also be offered, where they meet the essential requirements, on prescription for smokers. Assist to quit smoking by means of the NHS is amongst the most cost-powerful [pdf] healthcare interventions there is. This is since smoking is so deadly that even although not all smokers do well in quitting, even with NHS help, the positive aspects for those that do are substantial. It truly is also 1 of the number of treatments that does not conform to the inverse care law, so that poorer more disadvantaged smokers are a lot more, not less, very likely to use NHS aid to quit. Supplying effectively regulated electronic cigarettes on prescription would make them accessible free of charge to the poorest smokers who locate it hardest to quit. I can not realize why you would be against that.

One hundred thousand smokers die prematurely in the Uk each 12 months, with 20 instances as several suffering from conditions induced by smoking. The numbers of youngsters taking up smoking have dropped dramatically but it’s nonetheless hundreds a day, 1000′s a week. This continues to be an epidemic of epic proportions and demands to be taken care of as this kind of.

EF I appreciate hugely your goodwill in in search of to comprehend and defend what you know is a loathsome habit. Value-effectiveness is developing more and more vital in the NHS, and a successful ex-smoker can dwell a vital lifestyle. But you know Britain, and its stubborn waywardness. Supplying correctly regulated electronic cigarettes on prescription would without a doubt conserve lives, a great number of, but there would be an equal amount who would rebel, just because they can. It really is part of the odd elegance of this nation, that we have a tendency to not like becoming advised what to do. And I reiterate: any smoker, no matter how poor, can afford replacement e-cigarette treatment: it functions, just about, it’s more affordable than true smoking, and the tars and harmful toxins are avoided. By all implies please press ahead with a drive for high quality regulation – but I strongly suspect that a lot of smokers are fairly aware of their personal fault, their own addiction, and would prefer to workout cost-free will, the free of charge will to not smoke, or not to be obese, or not be an alcoholic, rather than undergo a type of infantilisation.

DA You say that any smoker no matter how poor can afford to purchase electronic cigarettes. E-cigarettes are not inexpensive and creating high quality assured products available on prescription will inspire more smokers to get help from the NHS and so conserve lives. It makes no sense to say that due to the fact items are offered on prescription smokers will be put off employing them because they come to feel infantilised. The NHS exists to supply large quality, free healthcare at the level of want. Really rightly, it does not make moral judgments about people

I am an ex-smoker. A lot more usually than you I had my first cigarette when I was 10, and was a typical smoker before I left college. Two thirds of smokers are like me, they begin ahead of 18, which is why I say it truly is an addiction of childhood. Like most smokers I tried to quit several times. The notion that smokers pick freely to smoke is a unsafe illusion that is fostered by the tobacco industry. For some people quitting can be easy, but for most it is a struggle just request the smokers who are dragging their drips behind them outdoors any hospital.

Should the NHS give electronic cigarettes on prescription?