In 2017 the Health Information and Quality Authority (HIQA) delivered a health technology assessment (HTA) of the clinical effectiveness and cost effectiveness of pharmaceutical and non-pharmaceutical smoking cessation products and services.
In relation to e-cigarettes as an aid to smoking cessation, HIQA advised as follows: ''Although the currently available results for e-cigarettes are promising, there is insufficient evidence at present to reliably demonstrate their effectiveness as an aid to smoking cessation. It would be appropriate to await the results of ongoing trials before deciding whether e-cigarettes should be recommended for those for whom varenicline is not suitable.''
In relation to the safety of e-cigarettes, the HIQA assessment concluded that this remains an evolving area of research; while potentially safer than smoking, evidence on long-term safety has yet to be established.
In October 2020, the Health Research Board delivered the findings of an evidence review on electronic cigarettes. The review focused on the evidence available on three topics; the effectiveness of e-cigarettes for smoking cessation, electronic cigarette use as a gateway to subsequent smoking in adolescents, and on the health harms and benefits of electronic cigarettes.
With the provision that these products are still relatively new and that further study is needed, the review found that:
- Electronic cigarettes are as effective, but no more effective than, other nicotine replacement therapies for smoking cessation, at least for an observed period of six months
- Use of electronic cigarettes is associated with an increased likelihood of smoking in adolescents
- Electronic cigarettes are not harmless but may represent a reduction in harm relative to smoking.
The findings of the Health Research Board on the use of electronic cigarettes by adolescents underscores the importance of the proposed Public Health (Tobacco and Nicotine Inhaling Products) Bill. This General Scheme for a Bill contains measures aimed at the regulation of nicotine inhaling products, such as prohibiting the sale of these products to those under the age of 18, as well as the creation of an annual licensing system for those wishing to offer these products for retail sale.
Clinical guidelines on smoking cessation are also currently in the process of being finalised. These guidelines will set out evidence-based statements on best practices to help people stop smoking and will assist healthcare professionals and service users make decisions together about care.
I note the recent decision by the Medicines and Healthcare Products Regulatory Agency in the UK to publish updated guidance on licensing of e-cigarettes as a medicinal product. I will continue to monitor research on the safety profile and health impacts of these products and their effectiveness for smoking cessation.