E-cigarettes for low income smokers, advertising standards, mental health and medicinal licences were just some of the topics that crept into this week’s select committee hearing.

A panel of four experts were asked a number of questions and in general, the mood on e-cigarettes in the UK was largely positive.

The panel included Rob Morrison, Senior Regulatory Policy Executive at the Advertising Standards Authority (ASA), Professor Gillian Leng  from the National Institute for Health and Care Excellence (NICE), Professor John Newton of Public Health England (PHE) and Dr Ian Hudson, Chief Executive of the Medicines and Healthcare products Regulatory Agency (MHRA).

Quick to emerge in the line of questioning was the issue of nicotine reliance. One committee member asked why nicotine in e-cigarettes is complained about but nicotine gum is rarely mentioned.

“Is there a difference between nicotine gum which no one is worrying about and the nicotine in e-cigarettes?”

The difference was clarified by NICE representative Professor Leng, who explained that nicotine gum has been licenced under the medicines licencing route, whereas e-cigarettes and e-liquids have not.

“We know they are substantially safer than cigarettes. The risk is that we don’t know the long-term impact. They are 95 per cent safer than cigarettes but there is five per cent that we don’t know about,” she added. 

It was also clarified by the committee chair that it is the inhalation and flavours along with other elements in e-cigarettes which cause concern as opposed to just nicotine.

This led to the topic of GPs potentially being able to recommend e-cigarettes on prescription, something which has raised its head before and in other nations. PHE’s John Newton said e-cigarettes are the most popular quitting aid among smokers.

On this, Dr Ian Hudson of the MHRA said medically approving e-cigarettes was an alternative route, one that would involve a lot of trust for the MHRA and GPs who would need a level of confidence in the product they were prescribing. Dr Hudson told the packed committee room,

“We’re doing a number of things to see if we can encourage people to go through the medical route including myth busting guidance.” 

Professor Leng also commented on this proposal, saying NICE believes there is a “strong evidence base” of the benefits of healthcare professionals being able to prescribe vape products for smoking cessation. This may not come as a surprise giving the recent update to guidelines issued by NICE for healthcare workers, encouraging doctors to recommend e-cigarettes to patients who have been struggling to quit smoking for good. She added that while e-cigarettes can be marketed as “edgy, exciting, different,” clear clarity around a licenced product would be essential for the likes of GPs if medicines licencing were to be on the table.

“The question is whether it becomes a long-term lifestyle choice and there might be questions about that because of the way e-cigarettes are marketed.”

Mental health policy

Studies have shown that smoking is around twice as common among people with mental health conditions as in the general population however some charities have been slow to endorse e-cigarettes or update their smoking policies. One third of mental health trusts ban the use of e-cigarettes. The expert panel were asked why this is the case, given that PHE has endorsed e-cigarettes in both its evidence review and Stoptober campaign.

Professor Newton said,

“We’ve provided guidance to NHS trusts and employers on the basis for which they can base their own policies. It seems unlikely that an overall ban is the right approach. Any smoker that finds an NHS trust who has the opportunity to use e-cigarettes should be allowed to …”

The growth in short-fill production in recent months was questioned by one committee chair, who asked if there was scope for short-fills to fall under the TPD.

To this, Dr Hudson replied,

“We’ll have to see the way the sector goes and reflect on that. At the moment it falls outside the regulations.”

Dr Hudson also noted “the speed at which the market is changing,” and said it would be “premature” to review Tobacco Product Directive regulations merely a year into the scheme.

Rob Morrisson of the Advertising Standards Authority told the committee the ASA would not be against the medical licencing route.

“It’s not our intention to drive people away from the medical licencing route.”

He added that the ASA has been reviewing current advertising regulations where vaping is concerned and said there will be new guidelines issued in the coming months, hinting at health claims being included but did not specify details or an implementation date.

The hearing comes at a significant milestone for the vape industry, almost 12-months on from May 20 2017, the day the TPD fully came into effect.

Overall, the future of e-cigarettes in the UK looks promising for both the vape industry and for those who have quit or are trying to quit smoking for good.

According to this latest committee meeting, approximately 700,000 smokers have used e-cigarettes as a means to completely quit and have then stopped using e-cigarettes, proving a trend of being a smoker to vaping to resisting nicotine completely.

You can watch or listen to the hearing in full by clicking here.