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6 June 2014

At my firm’s recent conference in Manchester many pharmacy owners said they were already selling e-cigarettes, but at least one attendee refuses to sell them on ethical grounds.

Where ethical issues are engaged, it would be helpful for the profession to have guidance from its regulator.

The GPhC’s position is: “When deciding whether a product such as an e-cigarette should be sold from a registered pharmacy, we would expect the pharmacy owner and the Superintendent Pharmacist to consider relevant guidance from appropriate bodies …”.

The Royal Pharmaceutical Society’s position is unambiguous: “They should not be sold or advertised from pharmacies”. The Society says: “As the experts in medicine we cannot support the sale of products with limited scientific evidence on safety”.

My problem with this reasoning is that the Society also says there is no evidence for the efficacy of homeopathy and no scientific basis for homeopathy, yet it does not recommend a ban on sales or advertising of homeopathic products.

I can’t help but feel that advocating a ban on selling e-cigarettes from pharmacies is rather like King Canute trying to hold back the tide. It can’t be stopped, so it would be better to regulate it. Some e-cigarettes are already licensed as medicines.

In the case of those that are not, the EU published a revised Tobacco Directive this April. When it becomes law, probably in 2016, the regulation of e-cigarettes will seem like a combination of the law governing medicines and ordinary cigarettes.

For example, packs of e-cigarettes will not only have to carry health warnings, but also:

  • instructions for use and storage
  • contra-indications
  • possible adverse effects
  • include a list of all ingredients contained, and an indication of the nicotine content of the product and the delivery per dose, the batch number
  • and a recommendation to keep the product out of reach of children
  • the equivalent of a patient information leaflet. 

E-cigarettes have not been around long enough to know whether they are a good thing or not, so the Tobacco Directive requires Member States to look out for any evidence that their use is a gateway to nicotine addiction and ultimately traditional tobacco consumption among young people and non-smokers.

The debate over e-cigarettes is a healthy one and I hope that pharmacists will play an important role in the monitoring Member States will carry out.

This article was written by David Reissner.

For more information please contact David on +44 (0)20 7203 5065 or david.reissner@crsblaw.com.