​The NHS Turnaround On Vaping

Published by Paul Larter on 3rd Nov 2015

For many who have kept their ear to the ground or spend time keeping up to date on the news, the controversy surrounding vaping and electronic cigarettes whether from the WHO (World Health Organisation), The EU, various governments including our own and the NHS is truly nothing new. Over the last few weeks however there has been a change in the air, and no it's isn't a new flavour in someone's e-cig tank, this came straight from the NHS.

It turns out electronic cigarette use isn't quite as worrying and dangerous as was previously thought, for vapers this isn't news, over the last year or so even Cancer Research UK has weighed in positively about vaping. However, when the NHS itself comes out and states that electronic cigarettes in their many shapes, strengths and forms are approximately 95% less harmful and 40% cheaper than traditional cigarettes, more people have started to take notice, suddenly what was demonised isn't quite as worrisome as many might have thought. For vapers this is a great victory, monumental even.

The truth is that since the big e-cig boom a couple of years ago, while much noise was made in the media, regulations for or against haven't changed much:

[...]Currently EC are governed by general product safety regulations (UK and EU) which do not require that the products be tested before being put on the market. However, manufacturers can apply for a medicinal licence through the Medicines and Healthcare products Regulatory Agency (MHRA) [...]

from next year any EC not licensed by the MHRA will be governed by the revised European Union Tobacco Products Directive (TPD)[...].

The interesting point here is the TPD. They have some interesting findings which in summary:
[...] will introduce new regulations for EC or refill containers which are not licensed by the MHRA. The cap on nicotine concentrations introduced by the TPD will take high nicotine EC and refill liquids off the market, potentially affecting heavier smokers seeking higher nicotine delivery products.[...]

[...]The absence of non-tobacco industry products going through the MHRA licensing process suggests that the process is inadvertently favouring larger manufacturers including the tobacco industry, which is likely to inhibit innovation in the prescription market.[...]

When using the Smoking Toolkit Study (STS, England) we have roughly 2.6 million EC users in GB in 2015 (for comparison there are about nine million tobacco users) with a staggering percentage of those vapers using tank systems as opposed to the sealed cartridge suggested by the TPD. Many of these are formerly heavy smokers needing an average liquid strength of 18mg - 24mg, this may be affected in the push for limiting eliquid to a maximum of 20mg nicotine content, this may well prove to be a hindrance to heavy 20 plus a day smokers.

Given the statements above it seems there is a cloud in the silver lining as while the NHS deems electronic cigarettes to be a lot safer, the TPD is trying to limit nicotine concentrations and the choice of flavours and nicotine strength. Many vapers today prefer a nicotine level through mixing 2 different strengths together to form a preferable average, they also like to mix their flavours and create something unique to their palate, limiting that most likely won't affect things in the long run, however it does put a damper on things.

The other great point is the potential for electronic cigarettes to be offered on prescription moving forwards. This is a prickly issue as it will not only hurt ecig and eliquid vendors and companies but also classify vaping as medicinal, however there are things here that don't add up. While you can certainly make nicotine a medicinal drug, what if the nicotine is 0mg (0.0%) nicotine? If vaping becomes medicinal and via prescription, does this mean the traditional NRT (Nicotine Replacement Therapy) such as patches, lozenges, gum, inhalers and sprays will no longer be on shop shelves?

All in all the NHS turnaround on vaping was a triumph and certainly helped give a more realistic picture of what vaping is to the public but at the same time, there is a hell of a lot still to be done on this, things aren't quite clear yet and if vaping does become a prescription drug, it could and most likely will mean that the tax payer will foot the bill.


While perception on vaping is certainly improving, the legislation and regulation of it in a fair and productive way still has a long way to go. It is certainly worth keeping an ear to the ground on future developments in the NHS -electronic cigarette world