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Are e-cigarettes the ultimate NRT, asks Darush Attar-Zadeh, smoking cessation trainer and clinical leader for the respiratory pathway redesign project at Barnet CCG

They certainly could tick a lot of boxes that help smokers to stop or reduce their cigarette usage since they have the capacity to raise the blood level of nicotine quickly (by at least 10ng/ml in 10 minutes), they come in a formulation that avoids local side-effects and they incorporate sensory properties and behavioural rituals of the kind that help to make cigarette smoking so attractive.

Sales of e-cigarettes are growing at an exceptional rate. If, ultimately, this leads to more people quitting smoking or reducing harm, then it has to be a positive outcome. But there are a few things that concern me about e-cigarettes:

• They could be seen as undermining the smoke-free policy by confusing the issue of what is and isn't allowed indoors
• They could normalise vaping (especially among the young) and may be a precursor to smoking
• Selling e-cigarettes in pharmacies may give the public the impression that they are safe and tested.

If we are selling these items, then it's very important we are able to discuss the technique, dose, side-effects, cautions, contra-indications and duration of course. We can do this with licensed treatments because they have gone through rigorous clinical trials. So I look forward to a day when we can start recommending licensed e-cigarettes that don't undermine our smoke-free legislation.