UK health professionals told to encourage vaping: report

Public health

By Nicola Garrett

14 Feb 2018

Health professionals should encourage more smokers to make the switch to e-cigarettes, an updated review commissioned by Public Health England concludes.

E-cigarettes are not acting as a route into regular smoking among young people

Written by an independent panel of experts the review goes as far as stating the evidence is ‘compelling’ enough for e-cigarettes to be made available to NHS patients.  

It also calls for e-cigarettes to be made available in hospital shops alongside nicotine replacement therapies.

The review, which updates new evidence in the literature since the agency’s last report published in 2015, also calls for health professionals to inform smokers that “vaping is at least 95% less harmful than smoking” – a figure that has been the subject of much controversy between Australian public health figures and Public Health England (see our previous coverage here.)

The 243 page report also calls for “widespread misconceptions” about the relative risks from nicotine and tobacco to be addressed.  For example, it states that many thousands of smokers incorrectly believe that vaping is as harmful as smoking; with around 40% of smokers not having tried an e-cigarette.

Professor Ann McNeil, lead author of the report and a Professor of tobacco addiction at King’s College, London, said, “People smoke for the nicotine, but, contrary to what the vast majority believe, nicotine causes little if any of the harm. The toxic smoke is the culprit and is the overwhelming cause of all the tobacco related disease and death.

The review also finds no evidence to support the concern that e-cigarettes are a route into smoking for young people.

Linda Bauld, report author and professor of health policy at the University of Stirling, commented, “In the UK, research clearly shows that regular use of e-cigarettes among young people who have never smoked remains negligible, less than 1%, and youth smoking continues to decline at an encouraging rate.

“We need to keep closely monitoring these trends, but so far the data suggest that e-cigarettes are not acting as a route into regular smoking among young people,” she said.

However medical groups in Australia have maintained their opposition to any easing of access to e-cigarettes.

AMA president Dr Michael Gannon this week rejected calls from Australian Conservatives leader Cory Bernardi to decriminalise vaping with nicotine. Dr Gannon said there was little evidence to back claims that vaping would help smokers quit. 

“We’re hearing a lot of noise from advocates for e-cigarettes, and what they do every time is compare an e-cigarette to a traditional tobacco cigarette. Now, if we were starting at ground zero, in 1600, and we had the choice of these two products, I would gladly concede that e-cigarettes are a safer product,” he said.

“Our concerns are the fact that there’s a lot of evidence internationally about dual-use – people using both e-cigarettes and traditional tobacco cigarettes. There is not good evidence that they are a useful nicotine replacement therapy agent. If they were, the companies would have applied to the TGA, to the Therapeutic Goods Administration, to have them list it as such.”

The main findings of PHE’s evidence review are:

  • vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits
  • e-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more
  • e-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country
  • many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40% of smokers have not even tried an e-cigarette
  • there is much public misunderstanding about nicotine (less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine)
  • the use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million
  • the evidence does not support the concern that e-cigarettes are a route into smoking among young people (youth smoking rates in the UK continue to decline, regular use is rare and is almost entirely confined to those who have smoked)

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