Excellent. Thank you.
As we have heard, there is still some uncertainty about the use of e-cigarettes. They entered the UK market only 12 years ago, and because this technology is still so young, we do not know for certain what its long-term impacts on health will be. What we do know is that e-cigarettes are around 95% less harmful than conventional cigarettes, and because of that, an estimated 2.9 million people in the UK are using them to stop smoking. Each year, tens of thousands of people successfully use e-cigarettes to quit. A randomised controlled trial, published in the New England Journal of Medicine earlier this year, found e-cigarettes used in a stop smoking service to be nearly twice as effective as licensed nicotine replacement therapies, such as patches and gum.
The importance of e-cigarettes as a smoking cessation tool should therefore not be dismissed. However, that must come with the caveat—I think everyone has made this point—that using an e-cigarette is not completely risk-free. There has been a recent outbreak of serious lung injury in the US linked to vaping, although that has not been replicated in the UK. Currently, 3.6 million people vape in the UK, yet the number of cases of severe respiratory pathology associated with vaping is low and diverse, with reports over a long period.
I agree with ASH’s recommendation that e-cigarette users should buy vaping products, including e-liquid, only from mainstream suppliers that sell regulated products, because using black market products may carry lethal risks. They should report any adverse effects from e-cigarettes to the Medicines and Healthcare Products Regulatory Agency using the yellow card scheme. If they experience serious adverse effects that they think are due to vaping, they should immediately stop vaping and get advice from their doctor.
Has the Minister considered launching an e-cigarette safety education programme that will ensure that e-cigarette users know the risks, and what to do if anything goes wrong and they manifest any such symptoms? That may lessen the possibility of manifesting the same patterns that we have seen in the US of lung injuries linked to e-cigarettes.
The Committee’s recommendation 4 says that NHS England should issue e-cigarette guidance to all NHS mental health trusts, and the default should be to allow e-cigarette use by patients. As we have heard, people with mental health issues smoke significantly more than the rest of the population, and could therefore benefit significantly from using e-cigarettes to stop smoking. Encouraging and allowing patients in mental health units who are smokers to switch to e-cigarettes as a means of smoking cessation would allow them to engage with their treatment sessions in the facilities without the interruption of smoking breaks.
A third of the 50 NHS trusts that responded to the Committee’s survey ban the use of e-cigarettes. The Government have agreed to issue guidance to NHS trusts about e-cigarettes. Will the Minister please tell us when she anticipates that it will be published? I know that she might have to rush it out in the next couple of days, but she might have a magic wand and be able to do that. Doing so could allow patients in mental health units to engage more fully with their treatment, which could improve outcomes.
As the Committee has found, e-cigarettes have a role to play in our society and in the Government’s commitment to achieving a smoke-free generation. However, we must ensure that advice on the safety of e-cigarettes, both short and long term, is updated regularly and publicly, so that users have the most relevant and up-to-date information available to them. The Government must also consider the role that e-cigarettes play in mental health services and improving patient outcomes across the NHS.
Every contact counts, especially when it comes to smoking cessation, and none should be missed. However, due to the Government’s public health budget cuts since 2013, which I know the Minister is not personally responsible for, smoking cessation services have suffered, leaving the most vulnerable smokers behind, without any support to quit smoking. That must change. Again, I ask the Government to reverse those public health budget cuts, so that local authorities can provide the smoking cessation services that their local communities need and deserve. I look forward to the Minister’s response.