Smoking Cessation: Prescription of E-cigarettes

Jonathan Ashworth Excerpts

Monday 1st November 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care to make a statement to the House on the Government’s announcement that e-cigarettes will be available on prescription.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

I am grateful to the right hon. Gentleman for his question. Covid has been a stark reminder that our underlying health and lifestyle determine how resilient we are to new risks and diseases. Covid did not strike evenly. People who smoked, were overweight, or struggled with chronic conditions fared worse. We are determined to level up health for a society that is not just healthier but fairer.

Smoking rates are down to 13.9%—the lowest on record—but tobacco continues to account for the biggest share of avoidable premature death in this country. It contributes half the difference in life expectancy between richest and poorest. Action against smoking is therefore at the heart of our mission to level up. Our goal is for England to be smoke free by 2030. To support this goal, we have an ambitious tobacco control plan, and will soon publish a new plan with an even sharper focus on tackling health disparities. Our new Office for Health Improvement and Disparities will support this vital mission nationally and locally.

Ministers from my Department have long been clear, including in this place, that we support e-cigarettes as part of a gateway process for stopping smoking. Last week, the Medicines and Healthcare Products Regulatory Agency updated its guidance on licensing as medicines e-cigarettes and other inhaled nicotine-containing products. The updated guidance sets out the steps needed to license an e-cigarette as a medicinal product, as well as quality, safety and efficacy standards.

Having e-cigarettes as a licensed product will enable them to be available on prescription, which I know will give health professionals greater confidence in their use. I am happy to update the House further when we are closer to having a licensed product. We will continue to consider e-cigarettes, and indeed any other innovative ways of improving the health of our nation, so that we can end disparities and level up to a healthier and fairer country.

[Jonathan Ashworth]

We welcome the announcement that e-cigarettes will be available on prescription. It should be a really significant step in helping 7 million smokers to quit. As the Minister says, smoking kills; it leads to 90,000 deaths and 500,000 hospital admissions every year across the UK. I think she will find broad support for what she has announced, but the House would have preferred to have heard this first, rather than via a press release issued by the Secretary of State on Thursday evening.

The Minister says that she will return to the House when she has more detail. What is the timeframe for that, and when does she expect the first prescriptions for e-cigarettes to be issued? She will know that to those who find it hardest to quit, the offer of e-cigarettes will be important, but it would be much better if it were backed up with access to specialist support services. However, smoking cessation services have been cut by over £22 million in the last five years. Indeed, areas with high levels of heart disease, cancer and stroke are among those hit hardest by the cuts. For example, Dudley has had a 17% cut. Derbyshire, which is where her constituency is, has had a 20% cut. Hartlepool and Wolverhampton have had cuts of 81% to their smoking cessation services.

To be frank, there will be no levelling up unless health inequalities are tackled, and unless we prevent cancer, heart disease, stroke, chronic obstructive pulmonary disease and diabetes where we can, but that demands fully funded local public health services, whereas in recent years, the public health grant has been cut by £1 billion in real terms, and in the Budget last week, it was just maintained at present levels. As the Association of Directors of Public Health has warned, this will mean further

“significant… reductions in public health services and capacity across the country.”

Will the Minister guarantee no further cuts to smoking cessation services? She mentioned the tobacco control plan, which is supposed to be published this year. Can she tell us at what point in the next two months that will happen?

[Maggie Throup]

I welcome the right hon. Gentleman’s support on the issue we are talking about and on our ambitions to make this country smoke free by 2030.

On the MHRA, the updated guidance provided further details on the steps required to license an e-cigarette as a medicinal product. To achieve a licence, a product would need to meet the standards of quality, safety and efficacy expected of a medicinal product. If successful, that would potentially allow safe and effective products to be made available for prescription for tobacco smokers who wish to quit. The update provides clarification and gives more guidance to potential providers on that issue.

The right hon. Gentleman asked about timescales. We anticipate that if a product was put to the MHRA today, for example, there could be an 18 to 24-month process for that product to be licensed. At this stage, we could not say anything further than that, so we are quite a long way from any e-cigarette being licensed and provided as a prescription medicine.

The public health grant increased by £135 million in 2020-21 and by £55 million in 2021-22. With regard specifically to the public health grant for smoking services, it is up to the local authority to decide how it spends its allocation of funding, but in addition, in our long-term plan, we have committed to helping to drive smoking cessation for a number of different groups. We want to provide help with cessation plans for in-patients and pregnant women, and to provide support for those with mental health and learning disabilities to tackle their smoking addictions. All in all, a lot of money is being spent both at the public health level and at the NHS level. We will continue to make sure that we do whatever we can in our power to make England smoke free by 2030.