An online survey conducted by GPonline has found that a significant majority of GPs do not believe that e-cigarettes should be prescribed for those attempting to quit smoking.
Nearly 70% of doctors surveyed on the subject rejected this idea, while only 17% explicitly backed the existing Public Health England policy.
14% of the 448 doctors who responded were undecided, but recent evidence from a study in the United States could sway many doctors against the prescription of e-cigarettes, considering that the technology clearly emits numerous harmful chemicals.
The collective wisdom of the doctors goes against advice provided by the health authorities.
A report from the Royal College of Physicians, published earlier this year, advised GPs to promote e-cigarettes “as widely as possible as a substitute for smoking”.
It had been asserted by the report that e-cigarettes represent a viable harm reduction strategy, and the conventional wisdom on the subject initially was that e-cigarettes significantly less harmful than traditional tobacco products.
But this viewpoint is being increasingly challenged as research becomes available, despite the apparent enthusiasm for the technology from health authorities.
After its publication, the RCGP called on NICE to investigate whether e-cigarettes should be prescribed to patients.
However, despite the views of doctors, there is still a significant groundswell of clinicians willing to prescribe the technology.
37% of GPs said that they were likely or very likely to recommend e-cigarettes to patients who are trying to give up smoking, compared with just 28% who said they were either unlikely or very unlikely to recommend them.
The consensus of opinion from doctors is that there is currently insufficient information available, particularly on the long-term consequences of e-cigarettes, in order to provide advice to patients.
This is something that surely must be addressed if voting is to be recommended as a serious medicinal contributor to the cessation of smoking.
At present, the existing health authorities’ policy seems to be rather uninformed and misguided, and evidence is accumulating all the time that e-cigarette smoking could in fact have very serious consequences.
Responding to potential criticisms, a spokeswoman for NICE indicated that its public health guidance on reducing harm from smoking recommends licensed nicotine-containing products.
“We haven’t produced guidance that looks at e-cigarettes specifically. As is usual process, the DH or Public Health England would have to officially refer the products to us before we can appraise them.”
Electronic cigarettes are now available for free on the NHS, despite an ongoing debate about the safety of the technology.
Research last week suggested that e-cigarettes are in fact no safer than traditional tobacco products, despite the fact that some health experts have recommended smokers switching to the new vaping technology.
Under the new regulations, it will be possible for e-cigarettes to be prescribed by doctors, alongside other traditional aids to help smokers such as nicotine patches and chewing gum.
The technology is intended to be an aid to ultimately quitting smoking and cutting one’s dependence on nicotine, rather than a replacement for the traditional tobacco product.
But Scottish GPs said more research into their long-term effects is needed and public health minister Maureen Watt warned that they are “not risk-free”.
An American study has already asserted that electronic cigarettes may be as harmful as smoking.
The e-Voke, made by British American Tobacco, is the first e-cigarette to be licensed by the UK’s Medicines and Healthcare Products Regulatory Agency, and will now be available via traditional prescription.
This technology would otherwise cost £20, with replacement cartridges retailing at £10 per week.
By comparison, a week’s supply of nicotine patches and chewing gum costs in the region of £10.
Already, 5 per cent of the Scottish population uses e-cigarettes, yet BMA Scotland has banned them in public places, also outlawing their sales of people aged under 18.
There is still considerable concerns that e-cigarettes may not offer a legitimate alternative to traditional tobacco products, and also that they may not even be an effective way of quitting smoking in the longer term.
Dr Andrew Thomson, a GP in Tayside and a member of the BMA’s Scottish Council, commented on the decision, striking a note of caution about the impact of e-cigarette technology.
“Further research is needed to learn more about the long-term effects of electronic cigarettes to uncover whether they are an effective and safe way of reducing tobacco harm.”
BMA Scotland stated that it was up to individual GPs to decide whether to prescribe e-cigarettes to patients.
On the other hand, some general practitioners have indicated that they would be willing to prescribe the technology if required.
Dr Jean Turner, a patron of the Scotland Patients Association, commented that “if you spend money now helping people getting off cigarettes, it will save them a lot of misery in the long term and save the NHS money treating people with vascular and lung disease.”
Scottish MSPs have recently that a lot to restrict the advertising of te-cigarettes.
E-cigarettes are to be prescribed on the NHS for the first time in the New Year, but the health service still has to face logistical issues about introducing this policy.
It has been stated that there are fears that GPs could be overrun by people demanding this prescription.
It will soon be possible for doctors to hand the device to smokers who intend to quit the habit, a move that will reportedly cost the NHS in the region of £20 per person.
In addition, each e-cigarette prescription will cost £10 per week for the supply of patients cartridges.
The government believes that the technology is significantly less harmful than smoking, and that the government believes that this medicinal license application will have a significantly positive influence on public health.
It is predicted that this new prescription move will ultimately lead to long-term health budget savings.
And the decision has already been welcomed by the anti-smoking organisation Action on Smoking and Health.
It is already estimated that in excess of 2.5 million people utilise E-cigarettes, with the technology believed to be 95 per cent safer than tobacco.
Cartridges used in the rechargeable devices contain ‘pharmaceutical grade nicotine’, according to British American Tobacco.
While the public smoking policies introduced by the government previously have had a significant influence on the habit, around one in three people in the UK continued to smoke E-cigarettes.
At least 76,000 lives could be saved every year if all smokers switched to electronic cigarettes, according to Public Health England .
Numerous studies have been carried out on the effects of E-cigarettes, but owing to the short lifespan of the technology thus far, it is impossible to explore the long-term influence on health.
While E-cigarettes contain carcinogens and other toxic chemicals contained in tar from tobacco, e-cigarettes do not burn tobacco and so avoid delivering these substances.
Thus, the general consensus of opinion is that E-cigarettes are significantly safer than tobacco, even if there are no studies to back this up over anything other than a short-term timeframe.
However, there are also concerns about the normalisation of smoking E-cigarettes.
The emergence of e-cigarettes has led to fears that they will act as a gateway to smoking conventional cigarettes among those who have never smoked.
There is no evidence of this having occurred as of yet, but as the phenomenon becomes more popular it is possible that E-cigarettes could lead to more young people taking up the habit of smoking conventional cigarettes.
Nonetheless, the NHS has decided to reveal this policy in order to attempt to address the existing health situation.
But Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary, University of London, suggests that there is a possibility that E-cigarettes could become a new gateway drug.
“People who are attracted to e-cigarettes are the same people who are attracted to smoking. People who drink white wine are more likely to try red wine than people who do not drink alcohol.”
New research suggests that people who use marijuana may be more likely to develop prediabetes than those who have never smoked the substance.
A paper published in Diabetologia (the journal of the European Association for the Study of Diabetes) assesses a sample of 3,000 people across the United States.
And the findings of the study were that adults currently using marijuana work 65 per cent more likely to suffer from the form of poor sugar control that can lead to Type II diabetes.
Those involved in the study who no longer smoked cannabis, but had used it 100 times or more in their lifetime, also have a significantly higher chance of developing their condition.
This was found to be around 50 per cent greater than those who have never consumed marijuana in any form.
The study ultimately found that “marijuana use was associated with the development and prevalence of prediabetes after adjustment. Specifically, occurrence of prediabetes in middle adulthood was significantly elevated for individuals who reported using marijuana in excess of 100 times by young adulthood.”
However, although there was a high incidence of prediabetes indicated by the study, the research failed to establish a direct link between Type 2 diabetes and marijuana usage.
The authors, led by the University of Minnesota School of Public Health’s Mike Bancks, said: “It is unclear how marijuana use could place an individual at increased risk for prediabetes yet not diabetes.”
Thus, some confusion still reigns over the result of the study.
Data was gleaned from a group of more than 3,000 US citizens, all of whom are collectively participating in a study called the Coronary Artery Risk Development in Young Adults.
Each of these individuals were aged between 18 and 30 when they were recruited in 1985-86, and have now been participating for 30 years straight.
The percentage of those reporting use of marijuana among the group has declined significantly over the decades in which they have been involved in this huge piece of research.
Although there seems to be little understanding regarding how marijuana could be linked with prediabetes and not tied to diabetes, authors of the paper did at least suggest some possible reasons for this.
The paper proposes that the lack of a link to type 2 diabetes could be because individuals excluded from the study had higher levels of marijuana use and greater potential for development of diabetes.
Additionally, it is possible that marijuana usage may have a larger affect on blood-sugar control in the prediabetic range than for full, type 2 diabetes.
3.2 million UK adults have been diagnosed as being diabetic, with this figure expected to increase to 5 million by 2025.
But Europe’s EMCDDA drug agency suggested in its annual report on drug use in the continent, published in June 2015, that cannabis use among 15 to 34 year olds has halved in the UK over the last 15 years.
It is thought that this could be due to smoking-related legislation.