As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
…to be handed out… to smokers to get them off cigarettes.
Yes... Big C said that the NHS is spending a lot of money on vaping/prducts - Shooters was questioning that statement (a little passive aggressively if you ask me) - i'd say potentially handing out 1 million of them for free would suggest maybe they are.
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Happy to. Depends what you mean by 'available on the NHS'. They're not generally available on prescription, no. There are some caveats to this, as some ICBs (you may know them as CCGs, as that's what they used to be called until very recently) do provide funding for their GPs and other health professionals to distribute them as part of their smoking cessation service work, but that's very much a local decision and isn't generally the way most ICBs and GPs operate.
However, they are provided to patients/service users very freqeuently within community based services (i.e. non-acute settings), particularly in mental health services and health justice work the NHS do. They're literally encouraged by Public Health England policy (see below). In particular, section 8.3 "Ensure patients have access to vaping products and consider whether to provide them proactively to patients who smoke."
It's almost always disposable vapes too, and this is why I have such a keen eye on disposibles in particular. Not just the health & safety impacts of the act of vaping either - for example not that long ago we had a case where a young man barricaded himself in an area of a MH unit and managed to start a fire using just his disposible vape (cracked the thing open and used the battery in a way I didn't even know was possible - which I won't go into detail here for obvious reasons). Thankfully it wasn't too bad, but it could have been horrific, and led to a change in how we procure these devices going forward to try and prevent future events like that happening again.
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
It wasn't, but some interesting links there. Have explained above what I was talking about, hopefully it makes sense! As you've mentioned in your post, there is a couple of smoking cessation campaigns running this year - the NHS one as far as I'm aware has no (or limited) plans to distribute vapes, but I may be wrong as I'm not privvy to that scheme in my job, it's a national scheme and I'm more focussed regionally. Although if they change tactic and decide to give out free vapes I'll probably be involved at some level of it. The council led one which i think is that 'swap to stop' one you've mentioned definitely is though - it's the main strategy of the plan - central government asked local government authorities to apply for some of the pot of money to buy vapes with to distibute locally. Looks like the uptake has been pretty good too, which is encouraging (or maybe not, depending on your opinion on vaping I guess lol).
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
It wasn't, but some interesting links there. Have explained above what I was talking about, hopefully it makes sense! As you've mentioned in your post, there is a couple of smoking cessation campaigns running this year - the NHS one as far as I'm aware has no (or limited) plans to distribute vapes, but I may be wrong as I'm not privvy to that scheme in my job, it's a national scheme and I'm more focussed regionally. Although if they change tactic and decide to give out free vapes I'll probably be involved at some level of it. The council led one which i think is that 'swap to stop' one you've mentioned definitely is though - it's the main strategy of the plan - central government asked local government authorities to apply for some of the pot of money to buy vapes with to distibute locally. Looks like the uptake has been pretty good too, which is encouraging (or maybe not, depending on your opinion on vaping I guess lol).
Thankyou for your reply. Might I ask what money the NHS is spending on e cigarettes and vaping products if it’s not on the schemes outlined in the helpful links above.
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
It wasn't, but some interesting links there. Have explained above what I was talking about, hopefully it makes sense! As you've mentioned in your post, there is a couple of smoking cessation campaigns running this year - the NHS one as far as I'm aware has no (or limited) plans to distribute vapes, but I may be wrong as I'm not privvy to that scheme in my job, it's a national scheme and I'm more focussed regionally. Although if they change tactic and decide to give out free vapes I'll probably be involved at some level of it. The council led one which i think is that 'swap to stop' one you've mentioned definitely is though - it's the main strategy of the plan - central government asked local government authorities to apply for some of the pot of money to buy vapes with to distibute locally. Looks like the uptake has been pretty good too, which is encouraging (or maybe not, depending on your opinion on vaping I guess lol).
Thankyou for your reply. Might I ask what money the NHS is spending on e cigarettes and vaping products if it’s not on the schemes outlined in the helpful links above.
I've outlined it in the post above the one you just quoted. And that's just what I'm aware of too, there may be other examples. If you're asking how much money, I have no idea in total - you'd need to go down the FOI route to get that kind of information.
As far as I’m aware no e cigarettes or vaping products are available on the NHS. Quite why Big C in his job thinks the NHS are spending and I quote “a lot of money on e cigarettes and vaping products” I can only guess at. Perhaps he could correct me if I’m wrong.
Would he maybe be talking abut the "swap to stop" initiative? I believe that is planned in for this year unless i'm misinformed - 1 million free vape kits supposedly to be handed out
It wasn't, but some interesting links there. Have explained above what I was talking about, hopefully it makes sense! As you've mentioned in your post, there is a couple of smoking cessation campaigns running this year - the NHS one as far as I'm aware has no (or limited) plans to distribute vapes, but I may be wrong as I'm not privvy to that scheme in my job, it's a national scheme and I'm more focussed regionally. Although if they change tactic and decide to give out free vapes I'll probably be involved at some level of it. The council led one which i think is that 'swap to stop' one you've mentioned definitely is though - it's the main strategy of the plan - central government asked local government authorities to apply for some of the pot of money to buy vapes with to distibute locally. Looks like the uptake has been pretty good too, which is encouraging (or maybe not, depending on your opinion on vaping I guess lol).
Thankyou for your reply. Might I ask what money the NHS is spending on e cigarettes and vaping products if it’s not on the schemes outlined in the helpful links above.
I've outlined it in the post above the one you just quoted. And that's just what I'm aware of too, there may be other examples. If you're asking how much money, I have no idea in total - you'd need to go down the FOI route to get that kind of information.
Once again thanks and it’s obviously me being thick but if the NHS is not handing out these products and at present doesn’t intend to via GP’s and on prescription, is the NHS funding these other initiatives on smoking cessation, or are they funded by another pot of money external to NHS funds ?
The NHS do hand out vapes though, it's just they hand them out to certain patient groups - it isn't just anyone that wants it. Hence I used the example above that they are given to patients in MH/Health Justice settings as national policy to explain how they are actually used across numerous parts of the health system, just not much via the more publicly visible primary care settings (i.e. GPs, walk in centres, acute hospitals etc).
It's an extremely complicated thing to explain all the various funding streams that all work together to provide NHS services. The NHS has various strategies for smoking cessation locally and nationally, but if we focus on it at a local primary care level then overall responsibility for GPs formally sits with NHS England, but in practice nowadays ICBs in most places have full (or at least majority) delegation of commissioning powers for primary care in their area from NHS England. The funding of GPs is actually really complicated; GP practices are privately owned businesses run by individual GPs or GP Partnerships that the NHS commission to provide general medical services to the public in that catchment area - they're not directly employed by the NHS, they're contracted. Through their contract, ICBs assign pots of money to GPs for certain initiatives depending on the health needs of the local community - and one of them is smoking cessation. This can be in the form of NRTs, medications, therapies (hypnotherapy is becoming more popular) etc., so it's largely down to ICBs and their GPs how they want to spend that money and what will work well for their patient group. GPs have essentially a 'payment by results' type of contract with the NHS, so they're remunerated based on results - better outcomes for their patients means they will get more money/profit. Therefore GPs rightly make choices based on what they think will work. If you want to go down that rabbit hole look into the Quality and Outcomes Framework!
On a national level, NHS England runs campaigns and schemes nationally (you might see billboards, TV adverts etc) and funds these activities targeted at the population as a whole rather than local populations. The UK Health Security Agency (new name for what was previously Public Health England) is part of central government and works alongside, but separately, to NHS England on their own national strategies and campaigns. Hence why they're funding the swap scheme linked to above in this thread, and are using local authorities as the means to distribute them to people.
If you want to know about it from an NHS standpoint at a local level, GPs are usually pretty open about their smoking cessation funding and how they use it (and also intend to use it in future) if you ask them.
@Big C Very interesting so thank you. I have to say though that I’m still not really understanding the NHS spend on e cigarettes / Vapes. If it isn’t procuring the products itself and distributing them to the various cessation projects around the country I can only assume that the NHS is supplying the funding to those organisations ? How much are we talking about here please. If I’m correct in my assumptions we can basically say that the NHS is giving out free vapes but just not through GP outlets.
It does procure products itself, but doesn't distribute them externally; they're only for use within certain NHS services (as explained - MH, H&J etc).
What organisations are you referring to? I don't believe the NHS provide funding to external organisations for smoking cessation (unless you're counting GPs) - that's as far as I'm aware anyway, I can only comment in the area I work in, where this is delivered 'in-house'. No idea if any trusts/ICBs/GPs have outsourced that provision elsewhere. So no, the NHS is not giving out free vapes, except in settings it is mandated to do so by policy (as far as I'm aware).
If you really want to dig down and find out how much in total nationally the NHS is spending on it, then good luck with that. It would be almost impossible. You'd need to contact every NHS organisation and submit an FOI request to each one, if they don't publish it publicly already. There are hundreds of them. For reference, just in London there are 18 acute trusts, 16 mental health/community trusts, the LAS and 5 ICBs, IIRC. You can't think of the NHS as one big organisation, it's not how it works; it's a complex system.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
Yeah I wouldn't even try and work out who's funding them in your local area, there's definitely blurred lines between NHS outreach and local authority public health responsibilities there. Medway is even a weirder case as local authorities have quite a big role in there via their public health teams, and so with Medway being a unitary authority they could be doing something completely different to KCC in the rest of Kent. I've barely touched on the NHS national programmes, or where pharmacies fit in to all this (google Community Pharmacy Contractual Framework if you want something to read to put you to sleep). We've only just scratched the surface to be completely honest.
This bold bit struck a chord. It is nuts how un-joined up the whole system is. When I first started in the NHS, to demonstrate how complex the system is, a colleague came up with this scenario and it was actually useful to try and get my head around it. Imagine you're walking down a street, you collapse on the pavement and hit your head. This is your treatment route:
1) An ambulance is called for you and takes you to hospital - ambulance service is run by the local ambulance service (NHS) 2) You arrive at hospital and get seen by staff there - hospital is run by the acute trust (NHS) 3) They check you over, patch you up, decide it's stress related and refer you for support at the local mental health facility down the road - the MH facility is run by the local community/MH trust (NHS) 4) They give you short term urgent intervention/support and then refer you back to your GP for long term monitoring, prescribing and signposting - GP care is funded by the ICB (NHS) GP contract.
ICBs also work in partnership with ICSs (NHS) and ICPs (NHS), but I don't want to go down that rabbit-hole, as even I get confused as to how all that works! In those 4 short simple steps (this is a very simple treatment path too it must be said, in reality it would be way more complex) look how many different NHS organisations you've come across....
But anyway, I fear this thread has got completely de-railed - I only came on to give a brief bit of insight and it got out of hand, apologies!
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think I get it that much but I think where I’m probably being unnecessarily pedantic and thick maybe is that the NHS state that e cigarettes / Vapes are currently not available for free on the NHS when regardless of how convoluted the funding streams and platforms for supplying are, it would appear from Big C’s posts that in fact they are funding and providing both. To take it to its logical conclusion. If that money was not coming from the NHS in any of its guises then the cessation programmes would all but stop.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think I get it that much but I think where I’m probably being unnecessarily pedantic and thick maybe is that the NHS state that e cigarettes / Vapes are currently not available for free on the NHS when regardless of how convoluted the funding streams and platforms for supplying are, it would appear from Big C’s posts that in fact they are funding and providing both. To take it to its logical conclusion. If that money was not coming from the NHS in any of its guises then the cessation programmes would all but stop.
Ah OK, I think this is where you're getting confused then - the NHS have never said that no vaping products are supplied for free anywhere throughout the entire NHS support system, it's just that there are no vaping products licensed as stop smoking medicines in the UK. Therefore they are not available on prescription from the NHS or from a GP, which is 100% true.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think SHG's point is that these are generally funded by DHSC money to local government either specifically for these services or more generally though routes like the Public Health Grant (where the LA has choice over which area of public health their community needs investment in). Those services then often use NHS providers and staff but the funding is not NHS.
Not that it really matters whether the funding is NHS or DHSC. Health services do use vases to help people quit smoking. That isn't really the issue it's the whole generation of kids who have never smoked but have picked up vaping. I know the public health teams at DHSC have been working on how to tackle this for a few years now. I welcome the announcement about disposable vapes being banned and hope its soon.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think SHG's point is that these are generally funded by DHSC money to local government either specifically for these services or more generally though routes like the Public Health Grant (where the LA has choice over which area of public health their community needs investment in). Those services then often use NHS providers and staff but the funding is not NHS.
Not that it really matters whether the funding is NHS or DHSC. Health services do use vases to help people quit smoking. That isn't really the issue it's the whole generation of kids who have never smoked but have picked up vaping. I know the public health teams at DHSC have been working on how to tackle this for a few years now. I welcome the announcement about disposable vapes being banned and hope its soon.
And this (kids vaping who have never smoked) is where changing laws and legislating against a disruptive pop up industry is not how you do it. Parents don't give kids vapes, or at least the ones with brains and boundaries don't, shops that sell them to kids get shut down and hammered by trading standards exactly the same as with shops selling hooch, tequila rose, wkd, cider and bacardi breezers to kids. Those products are clearly aimed at youngsters who have a penchant for alcohol especially sweet alcohol.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think SHG's point is that these are generally funded by DHSC money to local government either specifically for these services or more generally though routes like the Public Health Grant (where the LA has choice over which area of public health their community needs investment in). Those services then often use NHS providers and staff but the funding is not NHS.
Not that it really matters whether the funding is NHS or DHSC. Health services do use vases to help people quit smoking. That isn't really the issue it's the whole generation of kids who have never smoked but have picked up vaping. I know the public health teams at DHSC have been working on how to tackle this for a few years now. I welcome the announcement about disposable vapes being banned and hope its soon.
And this (kids vaping who have never smoked) is where changing laws and legislating against a disruptive pop up industry is not how you do it. Parents don't give kids vapes, or at least the ones with brains and boundaries don't, shops that sell them to kids get shut down and hammered by trading standards exactly the same as with shops selling hooch, tequila rose, wkd, cider and bacardi breezers to kids. Those products are clearly aimed at youngsters who have a penchant for alcohol especially sweet alcohol.
I think, whilst leaving it just to an increase in existing enforcement is an interesting approach (although I don't agree with it), it's also totally unrealistic in the current climate local authorities work in.
Tobacco and vape enforcement already sucks up a large amount of enforcement focus from local authorities. Increasingly so as further cuts to councils happen to the point where some authorities already have sub-minimal resources set aside for this type of work. Or in the case of LB Enfield, just for example, none.
"Enfield council, in north London, may be about to lose its entire trading standards department. Three of its deeply diminished team of four are being sacked to save costs, and the remaining manager is resigning in protest..."
How are councils supposed to carry out compliance inspections, organise and undertake test purchases, maybe call and prepare a licence review or prosecute offenders (court dates are being given out years away btw) when there's two people in the department and vapes are sold in every other shop? And then, after managing to actually get a prosecution through, the business gets a £250 fine.
These products are inherently unsafe outside of clinical supervision. It's bonkers they're on sale alongside Haribo. Expecting already floundering local authorities to take on additional large scale market surveillance, without a massive, long term investment in resources is completely unrealistic IMO.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
I think SHG's point is that these are generally funded by DHSC money to local government either specifically for these services or more generally though routes like the Public Health Grant (where the LA has choice over which area of public health their community needs investment in). Those services then often use NHS providers and staff but the funding is not NHS.
Not that it really matters whether the funding is NHS or DHSC. Health services do use vases to help people quit smoking. That isn't really the issue it's the whole generation of kids who have never smoked but have picked up vaping. I know the public health teams at DHSC have been working on how to tackle this for a few years now. I welcome the announcement about disposable vapes being banned and hope its soon.
And this (kids vaping who have never smoked) is where changing laws and legislating against a disruptive pop up industry is not how you do it. Parents don't give kids vapes, or at least the ones with brains and boundaries don't, shops that sell them to kids get shut down and hammered by trading standards exactly the same as with shops selling hooch, tequila rose, wkd, cider and bacardi breezers to kids. Those products are clearly aimed at youngsters who have a penchant for alcohol especially sweet alcohol.
I think, whilst leaving it just to an increase in existing enforcement is an interesting approach (although I don't agree with it), it's also totally unrealistic in the current climate local authorities work in.
Tobacco and vape enforcement already sucks up a large amount of enforcement focus from local authorities. Increasingly so as further cuts to councils happen to the point where some authorities already have sub-minimal resources set aside for this type of work. Or in the case of LB Enfield, just for example, none.
"Enfield council, in north London, may be about to lose its entire trading standards department. Three of its deeply diminished team of four are being sacked to save costs, and the remaining manager is resigning in protest..."
How are councils supposed to carry out compliance inspections, organise and undertake test purchases, maybe call and prepare a licence review or prosecute offenders (court dates are being given out years away btw) when there's two people in the department and vapes are sold in every other shop? And then, after managing to actually get a prosecution through, the business gets a £250 fine.
These products are inherently unsafe outside of clinical supervision. It's bonkers they're on sale alongside Haribo. Expecting already floundering local authorities to take on additional large scale market surveillance, without a massive, long term investment in resources is completely unrealistic IMO.
I agree, however government interference isn't a substitute for them properly funding shit our taxes go towards like properly resourcing the police, properly funding local governments apart from the utterly backwards decision to remove Central government funding and expecting a service to pay for itself or turn a profit once some asset strippers get hold of a local or unitary authority under a PFI.
They are simply taking the option that works for them because its cheap and works for the massive tobacco industry that donates money and lobbies them.
If I think about it, trading standards is something that can pay for itself in the same way that litter wardens and parking wardens pay for themselves.
I find anything related to smoking / vaping a tough subject to talk about. My mum smoked 30 a day and died of lung cancer at the age of 55 in 2012. It spread to her brain and she was diagnosed after back pain in May and was gone on 8th August.
It was the most horrendous death. She couldn’t breathe and was begging to die in the hospice in her last days. After the brain cancer developed she forgot who I was and wasn’t even herself at the end.
All over a pointed white stick that smells.
My eldest was only 3 when she died and is 15 now. He knows perfectly well that if he ever even goes near a vape or a cigarette his backside won’t touch the floor. And I make no apologies for saying that.
If you’ve got kids or anyone that cares for you and you smoke or vape then please think of them. I know it’s so hard to give up but you CAN do it and they will absolutely love you for it in the long run.
I find anything related to smoking / vaping a tough subject to talk about. My mum smoked 30 a day and died of lung cancer at the age of 55 in 2012. It spread to her brain and she was diagnosed after back pain in May and was gone on 8th August.
It was the most horrendous death. She couldn’t breathe and was begging to die in the hospice in her last days. After the brain cancer developed she forgot who I was and wasn’t even herself at the end.
All over a pointed white stick that smells.
My eldest was only 3 when she died and is 15 now. He knows perfectly well that if he ever even goes near a vape or a cigarette his backside won’t touch the floor. And I make no apologies for saying that.
If you’ve got kids or anyone that cares for you and you smoke or vape then please think of them. I know it’s so hard to give up but you CAN do it and they will absolutely love you for it in the long run.
Comments
It wasn't, but some interesting links there. Have explained above what I was talking about, hopefully it makes sense! As you've mentioned in your post, there is a couple of smoking cessation campaigns running this year - the NHS one as far as I'm aware has no (or limited) plans to distribute vapes, but I may be wrong as I'm not privvy to that scheme in my job, it's a national scheme and I'm more focussed regionally. Although if they change tactic and decide to give out free vapes I'll probably be involved at some level of it. The council led one which i think is that 'swap to stop' one you've mentioned definitely is though - it's the main strategy of the plan - central government asked local government authorities to apply for some of the pot of money to buy vapes with to distibute locally. Looks like the uptake has been pretty good too, which is encouraging (or maybe not, depending on your opinion on vaping I guess lol).
It's an extremely complicated thing to explain all the various funding streams that all work together to provide NHS services. The NHS has various strategies for smoking cessation locally and nationally, but if we focus on it at a local primary care level then overall responsibility for GPs formally sits with NHS England, but in practice nowadays ICBs in most places have full (or at least majority) delegation of commissioning powers for primary care in their area from NHS England. The funding of GPs is actually really complicated; GP practices are privately owned businesses run by individual GPs or GP Partnerships that the NHS commission to provide general medical services to the public in that catchment area - they're not directly employed by the NHS, they're contracted. Through their contract, ICBs assign pots of money to GPs for certain initiatives depending on the health needs of the local community - and one of them is smoking cessation. This can be in the form of NRTs, medications, therapies (hypnotherapy is becoming more popular) etc., so it's largely down to ICBs and their GPs how they want to spend that money and what will work well for their patient group. GPs have essentially a 'payment by results' type of contract with the NHS, so they're remunerated based on results - better outcomes for their patients means they will get more money/profit. Therefore GPs rightly make choices based on what they think will work. If you want to go down that rabbit hole look into the Quality and Outcomes Framework!
On a national level, NHS England runs campaigns and schemes nationally (you might see billboards, TV adverts etc) and funds these activities targeted at the population as a whole rather than local populations. The UK Health Security Agency (new name for what was previously Public Health England) is part of central government and works alongside, but separately, to NHS England on their own national strategies and campaigns. Hence why they're funding the swap scheme linked to above in this thread, and are using local authorities as the means to distribute them to people.
If you want to know about it from an NHS standpoint at a local level, GPs are usually pretty open about their smoking cessation funding and how they use it (and also intend to use it in future) if you ask them.
Very interesting so thank you. I have to say though that I’m still not really understanding the NHS spend on e cigarettes / Vapes. If it isn’t procuring the products itself and distributing them to the various cessation projects around the country I can only assume that the NHS is supplying the funding to those organisations ? How much are we talking about here please. If I’m correct in my assumptions we can basically say that the NHS is giving out free vapes but just not through GP outlets.
What organisations are you referring to? I don't believe the NHS provide funding to external organisations for smoking cessation (unless you're counting GPs) - that's as far as I'm aware anyway, I can only comment in the area I work in, where this is delivered 'in-house'. No idea if any trusts/ICBs/GPs have outsourced that provision elsewhere. So no, the NHS is not giving out free vapes, except in settings it is mandated to do so by policy (as far as I'm aware).
If you really want to dig down and find out how much in total nationally the NHS is spending on it, then good luck with that. It would be almost impossible. You'd need to contact every NHS organisation and submit an FOI request to each one, if they don't publish it publicly already. There are hundreds of them. For reference, just in London there are 18 acute trusts, 16 mental health/community trusts, the LAS and 5 ICBs, IIRC. You can't think of the NHS as one big organisation, it's not how it works; it's a complex system.
If you were to Google 'smoking cessation services' and maybe add 'locally' to the end you would find a myriad of them. In Medway they have one, at one point my wife came home years ago with fidget toys, patches, and tons of leaflets from there for her dad, who in the end used vaping to stop smoking. That would have been funded from one of these NHS sources @Big c has mentioned.
You worked in the NHS and will.kmow better than most of us as users how un-joined up it is and how many various trusts and bodies there are the further down you cascade
This bold bit struck a chord. It is nuts how un-joined up the whole system is. When I first started in the NHS, to demonstrate how complex the system is, a colleague came up with this scenario and it was actually useful to try and get my head around it. Imagine you're walking down a street, you collapse on the pavement and hit your head. This is your treatment route:
1) An ambulance is called for you and takes you to hospital - ambulance service is run by the local ambulance service (NHS)
2) You arrive at hospital and get seen by staff there - hospital is run by the acute trust (NHS)
3) They check you over, patch you up, decide it's stress related and refer you for support at the local mental health facility down the road - the MH facility is run by the local community/MH trust (NHS)
4) They give you short term urgent intervention/support and then refer you back to your GP for long term monitoring, prescribing and signposting - GP care is funded by the ICB (NHS) GP contract.
ICBs also work in partnership with ICSs (NHS) and ICPs (NHS), but I don't want to go down that rabbit-hole, as even I get confused as to how all that works! In those 4 short simple steps (this is a very simple treatment path too it must be said, in reality it would be way more complex) look how many different NHS organisations you've come across....
But anyway, I fear this thread has got completely de-railed - I only came on to give a brief bit of insight and it got out of hand, apologies!
Not that it really matters whether the funding is NHS or DHSC. Health services do use vases to help people quit smoking. That isn't really the issue it's the whole generation of kids who have never smoked but have picked up vaping. I know the public health teams at DHSC have been working on how to tackle this for a few years now. I welcome the announcement about disposable vapes being banned and hope its soon.
Tobacco and vape enforcement already sucks up a large amount of enforcement focus from local authorities. Increasingly so as further cuts to councils happen to the point where some authorities already have sub-minimal resources set aside for this type of work. Or in the case of LB Enfield, just for example, none.
https://www.theguardian.com/commentisfree/2023/jun/20/trading-standards-uk-consumer-goods-britain-europe
"Enfield council, in north London, may be about to lose its entire trading standards department. Three of its deeply diminished team of four are being sacked to save costs, and the remaining manager is resigning in protest..."
How are councils supposed to carry out compliance inspections, organise and undertake test purchases, maybe call and prepare a licence review or prosecute offenders (court dates are being given out years away btw) when there's two people in the department and vapes are sold in every other shop? And then, after managing to actually get a prosecution through, the business gets a £250 fine.
These products are inherently unsafe outside of clinical supervision. It's bonkers they're on sale alongside Haribo. Expecting already floundering local authorities to take on additional large scale market surveillance, without a massive, long term investment in resources is completely unrealistic IMO.
They are simply taking the option that works for them because its cheap and works for the massive tobacco industry that donates money and lobbies them.
If I think about it, trading standards is something that can pay for itself in the same way that litter wardens and parking wardens pay for themselves.
😂
It was the most horrendous death. She couldn’t breathe and was begging to die in the hospice in her last days. After the brain cancer developed she forgot who I was and wasn’t even herself at the end.
All over a pointed white stick that smells.
My eldest was only 3 when she died and is 15 now. He knows perfectly well that if he ever even goes near a vape or a cigarette his backside won’t touch the floor. And I make no apologies for saying that.
If you’ve got kids or anyone that cares for you and you smoke or vape then please think of them. I know it’s so hard to give up but you CAN do it and they will absolutely love you for it in the long run.
I miss her every day.