The RCN has a number of members who are involved in smoking cessation and who advocate nicotine replacement therapies as part of a suite of options to encourage individuals to give up smoking. The RCN (along with other Royal Colleges) have previously stated that ‘Harm reduction in smoking can be achieved by providing smokers with safer sources of nicotine that are acceptable and effective cigarette substitutes.'
The Directive will bring forward new proposals to ensure that such products (including electronic cigarettes) below a certain nicotine threshold are allowed on the market but must feature health warnings; above this threshold such products are only allowed if authorised as medicinal products, such as nicotine replacement therapies.
The extent to which nicotine containing products impact on an individual’s health is currently an area where further research is being undertaken, although it is clear that the impact is minimal compared to continuing smoking, particularly in relation to safer sources of nicotine5. The RCN would therefore be concerned if a health warning placed on all products with low levels of nicotine led to a fall in individuals taking up nicotine replacement therapy who instead continued to smoke. Research on whether this would be the impact is unclear at present.
The proposals will include electronic cigarettes, which are defined as a nicotine containing product under this directive and would be authorised as outlined above. The RCN welcomes the principle of ensuring that e-cigarettes are regulated in some way given that there is currently no regulation of these devices.
The RCN is committed to ensuring that nicotine containing products can be regulated but in a more nuanced way than currently proposed. The RCN is aware of an alternative proposal from ASH that all nicotine containing products should be regulated as medicinal products, rather than distinguishing between those containing high and low levels of nicotine. This would mean that all nicotine containing products including e-cigarettes would need to meet quality and safety standards, advertising standards, allow for control on age of sale and market surveillance. The RCN supports this proposal, which would regulate these products but also allow each nicotine containing product to be approved as an individual product.