ELECTRONIC cigarettes have been included for the first time in official NHS Scotland guidance aimed at helping smokers quit.
The new advice recognises the increased popularity of the smoking simulators among people wishing to cut down their use of more harmful tobacco products.
It says that while those using NHS smoking cessation services should be strongly encouraged to adopt licenced nicotine replacement therapy (NRT), such as patches and gum, those wanting to use e-cigarettes should not be told to stop if there was a risk they would return to tobacco.
In the past it is believed some services have turned away those wanting to use e-cigarettes as part of their attempts to quit smoking, meaning they are denied other forms of support offered by the NHS such as group counselling.
Battery-powered e-cigarettes use a heating element that vaporises a liquid solution, normally containing nicotine, and sometimes flavourings. Many look like cigarettes due to the vapour that is emitted, leading health campaigners to claim they continue to normalise smoking to children.
The products currently face minimal regulation but, under rules agreed by the European Parliament, from 2016 those products making health claims will have to be regulated as medicines while others will still face tougher controls on nicotine content.
The new guidance in Scotland, produced for those running smoking cessation services by the special health board NHS Health Scotland and Action on Smoking and Health (ASH) Scotland, focuses on harm-reduction among tobacco users on the road to stopping use of nicotine entirely.
On the issue of e-cigarettes, it points out there is little evidence currently available on their quality, safety or effectiveness. “However, current expert opinion on the limited evidence available suggests that they are likely to be considerably less hazardous than tobacco smoking,” the guidance says.
It also acknowledges that growing use of e-cigarettes may lead to lower numbers of people using official NHS stop-smoking services, and it could be harmful to deny them access to other aspects of these services which would improve their chances of quitting.
Figures last week showed there were 103,431 attempts to quit smoking using NHS services in 2013 which was down by 13 per cent compared to the previous year. Experts said the fall could be partly explained by the rise in use of e-cigarettes.
The new guidance says smokers using quit services should always be encouraged to use licenced NRT products, but that the “priority should be to prevent relapse to smoking”.
It adds: “Therefore users of unlicensed products should not be advised to discontinue use of such products if it risks relapse to smoking.”
Fiona Moore, public health adviser at NHS Health Scotland, said people using e-cigarettes and not willing to swap to other products would be encouraged to access services in the hope of eventually coming off them.
She said increased interest and inquires about e-cigarettes had prompted them to revisit guidance, amid concerns the numbers using quit services were falling, meaning they might be missing out on the extra support these gave.
But she stressed that despite the new advice recognising a role for e-cigarettes in keeping some people off tobacco, the ultimate aim was to remove reliance on nicotine entirely.
“There is a risk that maybe if people can’t access the brand of e-cigarettes they use, it might be easier just to buy ordinary cigarettes and that would be them re-hooked,” Moore said.