Whilst recognised health organisations such as Cancer Research UK and Action on Smoking and Health (ASH) publicly backed vaping, the British Medical Association (BMA) had remained stubborn on its scepticism toward vaping.

Thanks to the growing positive research and opinions from health professionals, the Doctor’s Union has now changed its mind and has decided that its members, your NHS doctors, should now take a positive stance on vaping and its obvious and widely accepted potential to support smoking cessation.

 

Until this reversal, the BMA was one of the few establishments in the UK that remained hostile towards vaping. It was the BMA in 2013, that wrote to a number of football clubs urging them to end sponsorship deals with e-cigarette companies and to ban the use of e-cigarettes at their football grounds.

Soon after, the association also called for e-cigarettes to be banned in public places, however this motion was dismissed by officials at Public Health England. Dr Mark Temple, BMA Cymru representative at the time, and Fraser Cropper, Totally Wicked Managing Director discussed e-cigarettes and the proposal of a Welsh vaping ban on BBC Radio Lancashire. Even in 2015, the opinion expressed by Temple on behalf of the BMA was remarkable in its hysterical delivery and preposterous misrepresentation of the facts.

Why the sudden U-turn?

A recent BMA policy document named E-cigarettes: balancing risks and opportunities outlines the reasoning and belated justification behind this decision.  The BMA references the regulatory framework as a key contributor and defines its future perspective and positioning of vaping:

Safety of e-cigarettes

The BMA has utilised research and expert views from health professionals and academics, to form its position which is summarised as:

“– There is growing consensus that using an e-cigarette is significantly less harmful than smoking tobacco.

– The short-term health risks associated with e-cigarette use appear minimal, but it remains important to monitor any potential long-term health impact on users.

– While the flavourings used in e-cigarettes do not appear to have an acute impact on the health of users, it is important that any long-term assessment of e-cigarette safety includes a focus on flavouring components.” 

 

The position also sheds light on the BMA’s previous concerns over the risk to children and the risk to bystanders.

The risk to children ties in with the gateway theory which is a theory that has been discredited for a number of years, with the theory suggesting that vaping will be a gateway into smoking for the young. Referencing previously available evidence, the BMA states as part of its position change that… “youth cigarette smoking has declined over the period of time that e-cigarettes have become increasingly available” while explaining that few children are becoming vapers and nearly all of those who are, currently smoke or have previously smoked.

With regards to bystanders and the risk of passive vaping, the BMA states “Current data on smoking and e-cigarette use does not support concerns that e-cigarettes are re-normalising cigarette smoking or undermining compliance with smoke-free legislation.”

E-cigarettes and smoking cessation

Smoking cessation is one of the most important topics in the Public Health remit as smoking is the leading cause of preventable death. Support from a range of health organisations is readily available, notably Nicotine Replacement Therapies, however e-cigarettes have proved to be the most popular method for smokers looking to quit. The BMA accepts this and documents it in the position, however the organisation is unwilling, as others have, to justifiably credit vaping’s contribution to the decline in smoking prevalence in the UK. Its agenda to regain control over smoking cessation for NHS services is clear in its persistent and reiterated demand that there should be a ‘prescriptible’ vaping option for health care providers, discrediting the private sector’s contribution to the success achieved to date.

The BMA’s next steps

The BMA also looked ahead to how e-cigarettes can be best utilised to support tobacco harm reduction and help “achieve a tobacco-free society, where there is significantly reduced mortality from tobacco-related diseases.”

Emphasis is placed on the importance of a thorough regulatory system, which ensures the products are safe and effective while keeping children and young people safe. Although the potential for medically licensed e-cigarettes is unclear and health professionals would primarily promote licensed products such as NRTs, the policy explains that “Given the greater popularity of e-cigarettes as a quitting aid, it is important to ensure that those choosing to use an e-cigarette receive sufficient support in their quit attempts.”

Perhaps the BMA has finally come to its senses and now believe that products driven by commercial organisations are in fact superior as cessation aids, to those that are controlled by themselves.

With the vast majority of UK health organisations now backing e-cigarettes it seems as though the BMA has been backed into a corner, forcing its members to replace their stubborn entrenched and unsupported position, with a much more considered and positive position on vaping and its contribution and potential in smoking cessation. While this decision appeared to be the only sensible approach that the BMA could take, the change of perspective is a significant step for vaping and continues the slow yet consistent shift in the UK to an embracing of vaping by influential organisations.  Well done BMA, shame it took you so long!

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