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Position statement on e-cigarettes by Public Health Nottinghamshire County

It is recognised that e-cigarettes are thought to be less harmful than cigarettes but are not harmless and recent guidance from PHE has estimated e-cigarettes to carry only around 5% of the risk of smoking for users, and exposure to vapour is therefore unlikely to present the risks of secondhand smoke. One in 2 lifelong smokers dies from their addiction. All of the evidence suggests that the health risks posed by e-cigarettes are relatively small by comparison but we must continue to study the long term effects.

The best thing a smoker can do, for themselves and those around them, is to quit completely, now and forever. However, for those people who are unable or do not want to stop in one step, Public Health Nottinghamshire supports the approach set out in the NICE public health guidance on tobacco harm reduction. This could include cutting down before you quit or long-term use of licensed nicotine-containing products.

Current evidence suggests that e-cigarettes can help smokers quit but are no better than other forms of Nicotine Replacement Therapy on the market. We acknowledge the increasing numbers of smokers in Nottinghamshire that are using e-cigarettes to help them cut down or to quit for good. Emerging evidence indicates that when the right product is used in the right way, e-cigarettes can be effective for both these purposes.

Locally we want as many people to stop smoking as possible and to reduce the harm tobacco use has on families and communities. Our local stop smoking services are e-cigarette friendly and although they cannot supply the e-cigarettes, they can provide that vital behavioural support and licensed free or subsided nicotine replacement products that can make the all-important difference in helping people to stop smoking.

The challenge is to maximise the public health benefits from e-cigarettes while managing the risks. We want to see safe and regulated e-cigarettes act as a route out of smoking for adults without becoming a route into smoking for young people and non-smokers. We strongly support proportionate regulation to secure high standards of product safety and effectiveness. This is now further supported by new legislation to prohibit sales and proxy sales to under-18s.

Public Health Nottinghamshire is aware of the E-voke electronic cigarette that has recently received a medicinal licence from the Medicines and Healthcare products Regulatory Agency (MHRA).

This is an interim statement and Public Health Nottinghamshire will continue to monitor the evidence on the impact of e-cigarettes on individuals and the population at large.

Please see the attached document for a printable version of this statement with references and links.

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