E-cigarettes are being promoted in England as part of the government’s efforts to help people quit smoking tobacco at the same time as it cracks down on youth vaping. We take a look at why there are two very different campaigns on the devices.
What are e-cigarettes?
There are a variety of e-cigarettes, or vapes, on sale in the UK but they generally work in a similar way: heating a liquid to produce a vapour that can then be inhaled. The liquid usually contains nicotine and chemicals including propylene glycol, vegetable glycerine and flavourings.
The use of vapes is on the rise. The majority of adults in Great Britain who vape are current and former smokers. There are concerns, however, about children using them. According to a 2022 YouGov survey carried out for the charity Action on Smoking and Health (ASH), almost 16% of 11 to 17-year-olds had tried vaping, compared with just over 11% in 2021 and almost 14% in 2020.
Are vapes safe?
That depends a bit on context. Vaping is regulated far more rigorously in the UK than in the US, where there have been concerns about lung disease and deaths associated with the liquids used in certain vapes.
But that doesn’t mean there isn’t nuance.
The importance of e-cigarettes in helping tobacco smokers quit lies in their relative safety compared with traditional cigarettes. Tobacco smoking is the leading cause of preventable illness and death in England. Cigarette smoke kills about 65,000 people a year.
E-cigarettes often contain nicotine, but they do not produce tar or carbon monoxide, which can cause lung disease and cancer, as traditional cigarettes do.
ASH also notes that vapes are a more effective quitting aid for tobacco smokers than nicotine patches or gum.
As a result, e-cigarettes play a key role in the government’s efforts to reduce smoking rates in England to 5% or less by 2030. About 5.4 million people in England, or 13% of the population, currently smoke tobacco, according to recent figures.
But that doesn’t mean that e-cigarettes are deemed suitable for all. Many, including ASH, say the devices are not recommended for children and non-smokers. That’s because e-cigarettes are not completely risk-free.
As the NHS notes: “The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke, but at a much lower level.”
There are also concerns that young people and non-smokers could become hooked on the devices through nicotine addiction.
What has the government announced?
The UK government intends to boost the uptake of e-cigarettes among smokers while reducing it among children.
One announcement is that about a million smokers in England are to be offered a free vaping starter pack in a “swap to stop” scheme. The government will provide funding and the scheme will be centrally organised, but local authorities will be able to tailor the initiative to their needs and control how they prioritise populations.
The government has also announced it will offer vouchers and behavioural support by the end of next year to all pregnant women who smoke tobacco, in an initiative that is hoped will cut the risk of miscarriages and stillbirth and reduce the number of babies born with health problems.
At the same time it is also providing £3m to create a specialised “illicit vapes enforcement squad”. The unit, led by Trading Standards, will be tasked with tackling the sale of banned vapes and underage sales.
What do experts make of the new plans?
On the whole, charities and scientists have backed the announcements, which appear to be based on some, but not all of the suggestions in the Khan review on making smoking obsolete, published last year.
Prof Peter Hajek, the director of the tobacco dependence research unit at Queen Mary University of London welcomed the rollout of the devices for helping people to quit.
“Vaping and other low-risk nicotine products have a potential to practically eradicate smoking-related death and disease,” he said. “This new step is a sensible, pragmatic and science-based initiative and good news for public health.”
He also said that while young non-smokers experimented with vaping, very few progressed to daily use, and that vaping had much lower addictive potential than cigarettes.
Alan Boobis, emeritus professor of toxicology at Imperial College London, also stressed that e-cigarettes were appreciably safer than conventional cigarettes, but that measures were needed to prevent take-up by youth.
“The most recent studies support a role for vaping in helping smokers to quit and hence I think the government’s initiative is a good idea as part of a broader range of measures to reduce the burden of ill health caused by smoking,” he said.
