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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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Stop SmokingAugust 26 2015

Use of NHS Stop Smoking services has continued to decline, with the numbers of people setting a quit date down 23% in a year. While a fall in smoking prevalence may be a factor for the decline, increasing use of e-cigarettes is also a likely explanation, suggests the Health and Social Care Information Centre.

HSCIC says that 450,582 people set a quit date through the NHS Stop Smoking Services in 2014-15, down 23% on 2013-14; of these, 229,688 (51%) self-reported they had quit. In addition, “the success rate of giving up smoking generally increased with age for both men and women, with 41% for those aged under 18 successfully quitting compared to 57% of those aged 60 and over.”

This is the first time the numbers of people setting a quit date has fallen for three consecutive years, since NHS Stop Smoking Services (previously Smoking Cessation Services) were set up in all Health Authorities in England in 2000, says HSCIC.

Its ‘Statistics on NHS Stop Smoking Services in England April 2014 to March 2015’were published at the same time that Public Health England published an expert independent evidence review saying that:

  • the current best estimate is that e-cigarettes are around 95% less harmful than smoking
  • nearly half the population (44.8%) don’t realise e-cigarettes are much less harmful than smoking
  • there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers
  • when supported by a smoking cessation service, they help most smokers to quit tobacco altogether.

The Proprietary Association of Great Britain, the trade body for OTC medicines manufacturers, called for more government investment and support to reverse the decline in use of local Stop Smoking Services.

Donna Castle, PAGB Director of Public Affairs and Communications, said: “The use of Stop Smoking Services is declining at an alarming rate because service funding is being cut. We are calling on national and local health policy-makers to recognise the valuable contribution that Stop Smoking Services can make to individuals, the NHS and the economy and to highlight the immediate need for sustained investment.

“Although smoking prevalence overall is decreasing, trends suggest this may plateau. There are considerable inequalities in rates of smoking so we must ensure that smokers continue to have access to the most effective interventions to support their quit attempt, which evidence shows to be licensed smoking cessation therapies, such as nicotine replacement therapy (NRT), delivered in conjunction with behavioural support through Stop Smoking Services.”

Responding to the evidence supporting the potential role for e-cigarettes in smoking cessation, the Royal Pharmaceutical Society acknowledged the PHE report adds to the growing body of information about the use of e-cigarettes.

However, RPS Director for England Howard Duff warned that “e-cigarettes are currently unlicensed products with no standardisation of safety, quality or efficacy. As such, we believe they should not be sold or advertised from pharmacies.

“We echo the views of PHE and support the original intention of the MHRA to regulate e-cigarettes as medicinal products as an aid to smoking cessation. The licensing process would align e-cigarettes with other nicotine reduction therapies and ensure quality control and standardisation of products.

“E-cigarettes contain less harmful toxins than tobacco but still contain nicotine, which is an addictive substance. As they are a very new product, no-one can be sure of the consequences of long-term use on health and further research is needed to determine this.”

Other reaction to the PHE report has generally been supportive. The Royal Society for Public Health said: “We hope that this clear guidance from PHE will encourage further uptake by smoking cessation services to embrace e-cigarettes as another tool in the box to support smokers to quit cigarettes

“While the public health community would prefer for no one be addicted to a substance such as nicotine, harm-reduction should be a priority. It is increasingly apparent that e-cigarettes can help people to quit smoking tobacco and we hope that this becomes more widely recognised by smokers.”

Asthma UK said: “In the future, we hope that e-cigarettes prove to be an effective and safe smoking cessation aid. Asthma UK is calling for more research into the long-term effects of e-cigarettes. Until then, it is up to each person with asthma to decide whether they are comfortable with the unknown, long-term risks of e-cigarettes in contrast to the known health risks of smoking tobacco products.”

Links:

HSCIC ‘NHS Stop Smoking Services In England April 2014 to March 2015’                

PAGB statement                

PHE announcement       

PHE ‘E-cigarettes: an evidence update’

RPS statement

RSPH statement              

BHF statement

Asthma UK statement  

Cancer Research UK statement                

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