E-cigarettes an evidence update A report commissioned by Public Health England

E-cigarettes: an evidence updateNevertheless, EC are penetrating the lower socioeconomic groups. Figure 13 shows thesocial class breakdown of EC users by quarter over time, also derived from STS data.Figure 13: E-cigarette use by social class over time (STS data)100%90%80%70%60%50%40%30%20%10%0%Q1 Q2 Q3 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q12011 2012 2013 2014 2015EDC2C1ABFrom www.smokinginengland.info/latest-statistics/E-cigarette use in other disadvantaged groupsThere are no GB data, to our knowledge, on EC use among groups where smokingprevalence is known to be very high, such as offenders and people with serious mentalillness. There is emerging evidence on the effectiveness of EC in people with mentalillness (see Chapter 6). However, to some extent, usage among these groups will bedependent on EC policies being introduced in prisons and mental health settings.Recent NICE guidance on smoking cessation in secondary care settings [30]recommended the implementation of smokefree policies in these settings, alongsideadvice to stop smoking and nicotine dependence treatment. Trusts are nowimplementing this guidance but many prohibit EC usage as well as cigarettes. Therationale for such prohibition is unclear.The South London and Maudsley NHS Foundation Trust (SLaM) was the second NHSmental health trust to go comprehensively smoke free in England. It has developed anEC policy alongside the smokefree policy which allows EC to be used in private spacesor grounds, although EC are not to be offered as first line treatment or replace tobaccocigarette smoking and can only be used as part of a care treatment pathway [31].Currently, the use of disposable products or rechargeable models with cartridges isallowed (the latter only under supervision), but tanks are prohibited because of fears43