Vaping products - tightening rules on advertising and promotion: consultation 2022

Using vapes to quit smoking

15. Despite tobacco’s long history of use, the link between smoking and lung cancer was not clearly made until the early 1960s. Evidence now shows that smoking is linked to a range of cancers and health conditions. While the impact on each individual smokers varies, the longer someone smokes the higher the risk.

16. On average, if someone starts to smoke at a young age, the risks increase later in life with signs of health damage beginning around the age of 40 and beyond – 20 or more years after starting smoking tobacco.

17. The time-lag between taking up tobacco smoking and the development of disease is a cause for concern. Smoking kills and even smoking one cigarette a day has been shown to increase an individual’s risk of developing coronary heart disease and stroke^[13].

18. In November 2017, the British Medical Association’s Board of Science published a position paper which aimed to balance the risks and opportunities associated with the use of vapes^[14]. While acknowledging that the inhalation of chemicals in vapour is not risk-free and long-term scientific evidence is required to fully understand impact, the BMA position paper summarised that while some of the harmful chemicals found in tobacco smoke were also found in aerosol from vapes, they were at much lower levels. People who switched from smoking tobacco cigarettes had significantly lower levels of the harmful chemicals in their bodies.

19. Latest advice suggests that vaping is likely to be less harmful than tobacco products, which, when smoked, contain over 5,000 chemicals. The Royal College of Physicians believes that “the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.”^[15] Whilst the College promotes the use of e-cigarettes as a safer alternative to smoked tobacco, we do not consider that degree of harm acceptable to young people or adult non-smokers.

20. Cochrane, in 2020, reviewed the effectiveness of electronic cigarettes as smoking cessation aids concluding success rates to be twice that of Nicotine Replacement Therapies.^[16]

21. However, dual use – smoking combustible cigarettes and using vaping products – is not believed to reduce the risk of adverse health effects associated with smoking tobacco products and may even increase the overall risks from nicotine exposure.^[17] It is important that individuals wishing to quit smoking tobacco products be able to access information and advice on cessation approaches, which include vaping.

22. The Scottish consensus statement on e-cigarettes was created by NHS Health Scotland in 2017 in collaboration with public health experts including the Royal College of Physicians, Health Boards, ASH Scotland and various academics. It reached agreement that, based on current evidence, vaping is less harmful than smoking tobacco^[18]. It states:

“Although most e-cigarettes contain nicotine, which is addictive, vaping carries less risk than smoking tobacco. Thus, it would be a good thing if smokers used them instead of tobacco”.

“Using e-cigarettes without stopping smoking (dual use) does not provide health benefits. Anyone who is using both should be strongly encouraged to stop smoking tobacco as soon as they can”.

“To be absolutely clear, e-cigarettes are useful for public health and health service purposes only as a potential route towards stopping smoking. Access to e-cigarettes needs to be controlled carefully; they are not products for children or non-smokers.”

23. Stopping smoking can have one of the largest impacts on improving someone’s health and vaping products have become a popular tool among those trying to stop or cut down tobacco use.

24. The Scottish Government recommend a variety of nicotine replacement therapy techniques and aids, of which vapes are just one tool.

25. The Medicines and Healthcare products Regulatory Agency (MHRA) published guidance in October 2021 for medicinally licensed e-cigarette products to be prescribed in England to help people quit tobacco^[19]. No decision has been made as yet by the UK Government on whether this approach will be taken forward.