Services Database Smoking Cessation Enhanced E-cigarette Service (Trafford)

This service aims to improve health outcomes and quality of life amongst Trafford
residents, through delivering smoking cessation advice and e-cigarette support to
identified smokers.

The harm of smoking comes from the chemicals produced when tobacco is burnt.
Whereas nicotine, the addictive substance that smokers are dependent upon and crave,
is relatively harmless. E-cigarettes provide nicotine in a significantly less harmful way
than burning tobacco, through heating a liquid of nicotine and an alcohol solvent to
create a vapour that the user inhales. Unlike cigarettes, no side-stream vapour is
emitted by an e-cigarette into the atmosphere, only the exhaled aerosol.

Public Health England’s review4 of the available evidence strongly supports the use of
e-cigarettes as a harm reduction tool in nicotine management. The review found that,
whilst not without some potential risk, the use of e-cigarettes over traditional tobacco
products reduced health risks by 95-98%. In England, e-cigarettes are the most popular
method used by adults trying to quit smoking compared to nicotine replacement therapy
(NRT) and varenicline. E-cigarette use is positively associated with successful smoking
quits and between April 2019 and March 2020, smoking quit rates involving a vaping
product were higher than any other smoking cessation method. To date, Public Health
England have identified no health risks of passive inhalation of e-cigarette vapour to the
health of bystanders.

The use of e-cigarettes is also supported by Greater Manchester Fire and Rescue
Service as a significant tool in the reduction of fire risk. There have been significant
developments in these devices in recent years and their safety record far outstrips that
of traditional cigarettes. Between March 2013 and March 2016, there were a total of
113 fires reported in England and Wales caused partly or wholly by e-cigarettes
(including the use of devices that would not meet recognised safety standards). In the
same time period, there were more than 16,000 fires related to traditional cigarettes; highlighting the reduced safety risks associated with e-cigarettes over cigarette
smoking.

There is a substantial evidence base (including a Cochrane review and randomised
controlled trials) that demonstrates that e-cigarettes are an effective tool for tobacco
dependence treatment and significantly more effective than NRT.6 The provision of e-cigarettes within primary and community care will help to improve health outcomes
and inequalities in adults across Trafford, while increasing the number of successful
smoking quits.

The objective of the Service is to ensure that any patient who is identified as a smoker
receives a consistent and effective offer, in line with NICE guidelines. This enhanced
service is to be provided in addition to the Essential Service ‘Promotion of Healthy
Lifestyles (Public Health)’ (ES4).