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Clinicians should recommend e-cigarettes to patients who smoke

In an article published today by Annals of Family Medicine, Professor Ann McNeill from King’s College London argues that for smokers who are struggling to quit or who do not want to quit, e-cigarettes - like other nicotine replacement therapies - offer a way of continuing to use nicotine but in a much less harmful way.
‘Cigarette smoking is uniquely dangerous with over 70 identified carcinogens and thousands of other toxins identified in cigarette smoke. On average, each cigarette smoked cuts someone’s life by 11 minutes and stopping smoking is arguably the single most important change that smokers can make to improve their health’, writes Professor McNeill.

‘As smoking is concentrated among the poor and disadvantaged in western societies, urgent action is needed to hasten all smokers’ ability to quit, in order to reduce growing health inequalities as a result of smoking.’

The article acknowledges that while more evidence is needed on their effectiveness for quitting, a Cochrane review published in 2015 indicated that electronic cigarettes were significantly more likely to help smokers to stop than placebo electronic cigarettes. In addition, electronic cigarettes also produce nicotine in a much less harmful way than tobacco cigarettes.

Professor McNeill adds: ‘Nicotine is the reason most people continue to smoke but it is not the nicotine that kills. Nicotine is most addictive when delivered quickly and in high doses, as with cigarette smoking. Other forms of nicotine substitution, including electronic cigarettes have not yet been shown to be so addictive although it’s possible this might change as technology advances in an effort to improve nicotine delivery. So for smokers who are struggling to quit or who do not want to, electronic cigarettes, like other nicotine replacement therapies, offer a way of continuing to use nicotine but in a much less harmful way.’

Professor McNeill concludes that by encouraging smokers to use whatever support is available to stop smoking - including e-cigarettes - healthcare professionals will help to ensure that tobacco cigarettes and smoking, as well as the associated mortality and morbidity burden, become obsolete within our lifetime.

Notes to editors

McNeill, A (2016) Should Clinicians Recommend E-cigarettes to Their Patients Who Smoke? Yes. Annals of Family Medicine

For further media information please contact Jack Stonebridge, Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King’s College London 020 7848 5377.