Community Pharmacists Perception Ana Marques Gomes Mpharm MRPharmS Shereen Nabhani Gebara PharmD BCOP Multidisciplinary research group Collaboration between Pharmacists Pharmaceutics expert and Analytical Chemists ID: 338478
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Electronic cigarettes: Community Pharmacists’ Perception
Ana Marques Gomes Mpharm, MRPharmS
Shereen Nabhani Gebara, PharmD, BCOPSlide2
Multidisciplinary research group
Collaboration between Pharmacists, Pharmaceutics expert and Analytical Chemists
Currents projects include
Public perception study (Poster presentation)
Role of e-cigarettes in the patient care pathway
Analysis
of content and distribution patterns of e-cigarettes and
e-refillsSlide3
E-cigarettes
Ruyan
Ltd.
(
Mr
. Hon Lik, Co-founder) introduced it in China in 2004 as an aid for smoking cessation and replacement.
Ruyan America's Chairman
,
Mr. Hon Lik
“I used to be a big smoker myself and knowing the harmful effects associated with it very well, I told myself I couldn’t go on like that. I tried nicotine patches but […] I missed the effect of the sudden impact, the act of smoking, the sensation of smoking. So I started thinking of a way to create vapor containing nicotine, similar to cigarette smoke but not as harmful for the organism.”
Ruyan literally means "Resembling smoking".Slide4
40 years later
-http://www.thevapestore.com/pages/how-does-it-work
[Accessed on line in April 2014]
-Patent no. US3200819 A. Gilbert Herbert A. 17 Ago 1965.
DesignSlide5
Over 2 million consumers now regularly use electronic cigarettes
In 2013, the MHRA announced they will be regulated by 2016
The Royal Pharmaceutical Society and The Chief Pharmaceutical officers in the UK strongly supported the MHRA’s decision
The EU Parliament voted for a dual supply route: medicinal products (if marketed as quitting aids) and tobacco products
-http://www.ash.org.uk/media-room/press-releases/:over-2-million-britons-now-regularly-use-electronic-cigarettes [Accessed on line in May 2014]
-Sukkar E. PJ online (1 March 2014), 292, 223-4. -Ridge KW, et al. Opinion/Letter section. PJ online (3 May 2014), 292, 473.RegulationsSlide6
Grana,
et al.
E-Cigarettes
: A Scientific Review
Based
on analysis of 82 studiesNicotine and toxins, including carcinogens, were identified in the exhaled aerosolThe nicotine content of the cartridge e-liquid revealed poor concordance of labelled contentMajor injuries have resulted from e-cigarette use, including explosions and firesCytotoxicity varied among products
There is little evidence of harmful effects in the short to medium term from repeated exposure to propylene glycol
Grana, et al. Circulation 2014; 129: 1972-86
Why regulation?Slide7
Bullen
C,
et al
.
RCT Investigating whether e-cigs are more effective than nicotine patches or
placebo e-cigarettes at helping smokers to quitn= 657 Verified abstinence at 6 months after quit dateNicotine e-cigarettes group (7.3%) vs Patches (5.8%), p-value= 0.46Placebo e-cigarettes (4.1%), p-value= 0.44 Concluded that among smokers wanting to quit, nicotine e-cigarettes might be as effective as patches for achieving cessation at 6 months. Identified no difference in adverse events
Bullen
C, et al. Lancet 2013; 382: 1629-37What is the evidence?Slide8
Brown
et al
.
A large cross-sectional survey of the English population.
n= 5863 adults who had smoked within the previous 12 months and made at least one quit attempt during that period with either
e-cigarette only NRT bought OTC onlyno aid Higher self reported abstinence with e-cigarette
Brown J, et al. Addiction 2014 Accepted Article What is the evidence?Slide9
Aim and objectives
The aim of this study was to gauge community pharmacists’ current experience and perceptions of electronic cigarettes
Objectives:
To evaluate the community pharmacists current experience with e-cigarettes
To gauge their perception on safety and current use
To gauge their perception on the upcoming MHRA regulations
To find out their training needs to be able to counsel patientsSlide10
Methods
Self-completion questionnaire was designed
Drop off-pick up method
Data was entered and
analysed
using MS Excel. Slide11
RESULTS & DISCUSSIONSlide12
Sample Profile
92/154 participants: 66
% male; 34% female
11% of
sample
from
big chains; the rest is small, independent
49% - Full time
37% - Locum5% - Part time5% Manager3% - SuperintendentSlide13
Sample Profile
Number of patients currently enrolled on smoking cessation services
73% of surveyed pharmacies sell e-cigarettes.
Of these only 3% of all e-cigarettes sales are nicotine-free.Slide14
Adverse effects
≈ 20% of our sample came across side effects from e-cigarettes reported by patients Slide15
Perception on use
Ranking
:
Smoking Cessation Aid
Relapse prevention
Public use (‘dual use’)
Social, recreational use Slide16
S
afety
and effectiveness
The design of e-cigarettes encourages smokers to give up
Nicotine delivery is more efficient with e-cigarettes than NRTs
Manufacturing of e-cigarettes is unreliable
E-cigarettes are safe for usersE-cigarettes do not cause any side effectsSlide17Slide18
Comparative EffectivenessSlide19
Perception of regulations
97% of pharmacists are in support of the regulations announced for 2016
Major benefits from regulations w
ere ranked as:
Reassurance of safety for users
Regulated as an established NRT
Increase profit for retail pharmacyPrevent the possibility of misuseSlide20
Stricter regulations are required for:Slide21
Training needs
83% of the survey pharmacists said they felt ready to stock and supply e-cigarettes under the new regulations.
There’s a need for training to support
counsellingSlide22
Training content
Safety
Dosage instructions
Adverse events
Implementation into smoking cessation patient care pathway Slide23
Conclusion
Widespread availability in pharmacies
Regulations welcomed
E-cigarettes perceived as effective with a potential role as a smoking cessation aid
Side-effects have been reported
Training needs
Slide24
Acknowledgements
Research Group
Dr Gianpiero Calabrese
Dr Reem Kayyali
Dr Steve Barton
Zohra YasminSlide25
Thank you for your attention