RCP statement on e-cigarettes

Tobacco is still the UK’s biggest public health issue, causing 100,000 deaths per year. For every death caused by smoking, approximately 20 smokers are suffering from a smoking-related disease. In England it is estimated that, in 2010–11, among adults aged 35 years and over, around 460,000 NHS hospital admissions were attributable to smoking, accounting for 5% of all hospital admissions in this age group.

The RCP has published several reports advocating harm reduction for people addicted to tobacco smoking, and particularly Harm reduction in nicotine addiction in 2007 [i]. The emergence and rapid growth in the use of electronic cigarettes since that report was published require a specific policy statement on their use. This statement was agreed by RCP Council in June 2014.

• The RCP recognises that electronic cigarettes and other novel nicotine devices can provide an effective, affordable and readily available retail alternative to conventional cigarettes. These innovations could make harm reduction a reality for smokers, as proposed in our 2007 report. [i]
• The RCP also recognises that these new products present potential risks as well as opportunities for individual and population health, and therefore advocates proportionate regulation to maximise the overall public health benefit.
• Regulation should ensure that products deliver nicotine effectively and safely; that advertising and promotion do not target young people or other non-smokers; and that advertising and use (for example, in public places) do not undermine smoking prevention policies. The RCP therefore supports regulation of electronic cigarettes and other novel nicotine products as medicines. [ii]
• Close monitoring of the use of electronic cigarettes in UK society is essential to ensure trends that are counter to public health are identified and acted upon promptly.
• On the basis of available evidence, the RCP believes that e-cigarettes could lead to significant falls in the prevalence of smoking in the UK, prevent many deaths and episodes of serious illness, and help to reduce the social inequalities in health that tobacco smoking currently exacerbates.

 

[i] Royal College of Physicians, 2007. Harm reduction in nicotine addiction.

[ii] The UK Medicines and Healthcare Products Regulatory Agency (MHRA) announced in 2013 that, from 2016, electronic cigarettes and other nicotine-containing products would be subject to medicines regulation, thus requiring manufacture to medicinal purity and delivery standards, and proactive controls on advertising. In addition, the European Tobacco Product Directive (TPD) will, from mid-2016 at the latest, prohibit most advertising of unlicensed nicotine devices and require products to carry health warnings, meet as yet undefined purity and emissions standards, require data on nicotine uptake, limit nicotine content, and require suppliers to take full-responsibility for quality and safety when used ‘under normal or reasonably foreseeable conditions’.