NNA Associate and Leicestershire Stop Smoking Services manager Louise Ross was asked to address pharmacists at the conference on Saturday on the subject of e-cigarettes. Louise was joined on the platform by vapers, who were able to share their personal experiences with delegates. Read on for Louise's account of the event, and for some wonderful news about the first quarter success rate of her ecig friendly service.
I was contacted in late September by the organiser of the Independent Pharmacy Federation Conference, who asked me to speak about ecigs. My name had been put forward by Dr Hayden McRobbie, Queen Mary University London, who wowed the audience at the national smoking cessation conference this summer, with his keynote speech about the power of alternative nicotine delivery devices to reduce the harm from smoking.
My first priority was to ask some vapers to come to the event with me. I’ve made a commitment never to speak at a ‘professional’ conference unless I’m sharing the platform with people who can talk from personal experience. I’d had replies within hours via Twitter (many thanks to all those who offered) and the first two to reply met me there. I’m grateful to @greyvapor and @Lollylulubes for telling their stories and making the audience open their eyes instead of closing their ears.
Our Stop Smoking service has got a long and successful history of working with pharmacists, who deliver the service as associates on our behalf. They’re great at engaging smokers who visit for prescriptions, over the counter medicines and all the other things offered in a pharmacy. They are trusted by the general public, and are a credible source of healthcare advice.
For this reason, I’ve been keen to get the message out to pharmacists that far from being the knell of doom for smoking cessation as we know it, ecigs (and by that I actually mean vaping in all its forms) hold huge potential to make a quit attempt much more successful, partly by being very popular with previously resistant smokers, and also by the possibility that if service users add these devices (bought themselves and without costing the smoking cessation services anything) to a standard treatment package, success rates could soar. When I quoted our Quarter 1 success rate (an extra 20%+ success with added vaping over NRT alone) it was a real sit-up-and-take-notice moment.
Questions were asked about titrating down, and what advice should be given about how to get off nicotine completely. There was consternation when I said that should be a personal choice: understandable from a body of people who have been schooled in guiding quit attempts to a natural conclusion of no nicotine at all. However, I pointed out that NICE PH45 on Harm Reduction states that staying on NRT for up to five years (maybe longer) has no adverse effects, and that the decision to use recreational nicotine long-term is a much better option than relapsing to smoking.
Other questions were raised about waiting for medical licensing. My personal opinion is that consumer legislation for a consumer product should be the goal, and that if medical regulation endorses a product that no one uses, what good is it? I would guess that if you get 100 vapers in a room, there will be 100 variations of what people like and find satisfying. This didn’t leave pharmacists feeling comfortable, but it was perhaps the first time they had considered that there was another route to quitting other than the pharmacological one. The Stop services stress how important the behavioural support is, and this can sometimes get lost in the search for the right pharmaceutical product.
An interesting question came from someone who had clearly been processing the information and wondering how to incorporate this approach into practice: it was about how pharmacists can find out what ecigs to recommend. We encouraged the audience to think ‘principle not detail’ – there is an enormous amount of information out there, in a fast-evolving field. Non-users would find it hard to gather enough information to make recommendations. People who want to know should look to reputable retailers, vaping forums, other users, and do their own research.
Personally, I learned a lot about the anxieties and interests of yet another professional group, who with the right insights could make a big difference to smoking rates in communities where radical change is needed most.
Stop Smoking Service Manager
Leicestershire Partnership NHS Trust