The approach taken towards e-cigarettes can vary drastically across borders but initiatives and policies can also deviate between various areas of the UK.
This may be the policies employed by NHS trusts, local cessation services or local public health councillors.
One third of NHS Mental health trusts still ban vaping on their grounds and around 25% of local councils fail to promote e-cigarettes in their tobacco control plans.
Although the positive evidence for e-cigarettes is building, clearly not all policy makers are convinced, hence this disparity in the approach to e-cigarettes.
The most recent oral evidence session for the ongoing e-cigarette inquiry took place in the House of Commons on 24th April. This disparity between different authorities was a prevalent topic and the witnesses present gave their views.
In the first part of the session we heard evidence from Rob Morrison (ASA), John newton (PHE), Gillian Leng (NICE) and Dr Ian Hudson (MHRA). In the second part of the session saw Steve Brine, undersecretary of state for public health and Tim Baxter, Director of healthy behaviours express their findings.
A third of NHS Mental Health Trusts ban vaping
Smoking rates of people suffering with poor mental health is a concern for public health in the UK. Despite this, a third of NHS mental health trusts ban vaping on their grounds.
The Science and Technology Committee was therefore intrigued as to why these trusts would impose this ban, even with all the positive evidence that surrounds e-cigarettes.
Professor John Newton, Public Health England (PHE) explained that PHE provides research to these trusts for them to make their own policies. He believes there is more value in each institute making their own policies so they can tailor them to their specific needs.
He also referred to the guidance for good practice for smoking cessation in mental health trusts, recently published by the NCSCT as he explained that it includes e-cigarettes.
Professor Gillian Leng added that NICE has a guidance on the subject, however she conceded that it is in need of an update and said it would be reviewed. She refused to give a time-frame on this update.
Directors of public health in local areas
Similarly to the NHS trusts, local councils are also given freedom to create their own policies regarding e-cigarettes.
Therefore in one local area e-cigarettes may be heavily endorsed by the respective cessation services, while in another area, vaping may not feature in their tobacco control plan.
We recently reported that Blackburn with Darwen Council public health director, Dominic Harrison was opposed to e-cigarettes as a cessation aid. With the majority of local public health directors taking a pragmatic approach and utilising vaping in cessation plans, this is a prime example of the disparity between councils.
In the parliamentary debate with the Science and Technology Committee, this topic was also raised.
John Newton explained that Public Health England (PHE) do work with these local public health directors and provide packages with advice and initiatives for them to utilise.
According to Newton, ‘we make it clear in our outputs that we think e-cigarettes should be part of local tobacco control policies’.
Steve Brine was also questioned about this subject. He was asked why 25% of local authorities were still dismissing e-cigarettes and what was being done to improve this.
Brine said that they would not mandate local councils to endorse e-cigarettes but they would continue to build the evidence base so that the decision is an easy one for them to make.
Does more need to be done?
It is relatively clear that these local authorities are given the freedom to make their own policies regarding e-cigarettes. With different authorities having specific priorities and circumstances this makes sense however is enough being done to ensure they make the right decision on e-cigarettes?
The Tobacco Control Plan published by PHE, the aforementioned NCSCT guidance and government campaigns such as Stoptober help to provide this evidence. Despite this, local policy makers are still choosing to ignore it and it could be having a detrimental effect on public health.
Not only may this have a direct impact on smokers who are being deprived of advice and support on e-cigarettes, the coverage of these policies encourage a negative perception of vaping.
In 2017, considerable cuts were made to the funding of local smoking cessation services. While it’s argued that the popularity of e-cigarettes may reduce the need for this funding, ASH reported that these cuts could have resulted in fewer people receiving evidence based support to quit smoking.
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