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HIQA to achieve ‘world first’ on e-cigarettes

HIQA’s latest health technology assessment (HTA) on smoking cessation will be the first in the world to include electronic cigarettes among the interventions examined.

“This has not been done by a national HTA agency up to now,” HIQA’s Director of HTA Dr Máirín Ryan told IMT.

Dr Ryan was speaking after the release last week (April 28) of a major new report from the Royal College of Physicians (RCP) in London, which concluded that e-cigarettes were much safer than smoking and likely to be beneficial to public health.

The report, ‘Nicotine without smoke: tobacco harm reduction’, found that e-cigarettes were not a gateway to smoking, nor did they result in normalisation of smoking behaviour. And while the possibility of some harm from long-term e-cigarette use could not be dismissed, this was likely to be very small.

“The available data suggest that [the long-term health risks] are unlikely to exceed 5 per cent of those associated with smoked tobacco products, and may well be substantially lower than this figure,” it suggested.

Reviewing the report in The BMJ (BMJ 2016;353:i1745), Prof John Britton, Chair of the RCP’s Tobacco Advisory Group, and colleagues argued that e-cigarettes and other non-tobacco nicotine products offered the potential to “radically reduce harm from smoking” in society. “This is an opportunity that should be managed, and taken.”

Dr Ryan remarked that this was one of the first endorsements from any clinical advisory body on the use of e-cigarettes, and was probably driven by the fact that E-Voke electronic cigarettes was licensed in the UK last year. She said HIQA’s expert advisory group was to have its first meeting at the start of July, so there was plenty of time to consider this latest report.

The smoking cessation HTA will examine the clinical and cost-effectiveness of a number of different treatments to help people quit smoking. “At the moment we are gathering the clinical effectiveness information in terms of the comparative clinical effectiveness and we will use that then to populate the economic model.

“It is a big budget area, but there is no shortage of evidence,” Dr Ryan added.

A public consultation on a draft HTA report is expected in October before it is finalised and submitted as advice to the Minister for Health and the HSE and published, most likely in December.

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