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PHE review supports use of vaping for smoking cessation

Public Health England (PHE) has released a new review of e-cigarette use, which supports the consensus that vaping results in harm reduction for smokers.

Additionally, PHE’s review found no evidence to support the concern that e-cigarettes may act as a gateway to smoking, with smoking rates among young people continuing to fall and e-cigarette use confined almost exclusively to those who have already smoked.

PHE’s assessment strengthens current practice of using e-cigarettes as a transition to smoking cessation.

As part of the Government’s Tobacco Control Plan for England, PHE was asked to update its 2015 evidence review on e-cigarettes. PHE commissioned a group of leading tobacco control researchers from the UK Centre for Tobacco and Alcohol Studies (UKCTAS) to produce the report, which underwent international peer review.

'The report reflects an up-to-date evidence base that is increasingly pointing in the same direction: not only that vaping is at least 95% less harmful than smoking, but also that it is helping increasing numbers of smokers to quit,' a PHE spokesperson said.

Although the number of UK vapers, currently at nearly three million, has plateaued since 2015, the proportion of vapers who continue to smoke has fallen year on year, dropping to below 50% for the first time last year.

It is now estimated that at least 20,000 additional successful quits per year can be attributed to e-cigarettes.

'Despite some experimentation with these devices among young people who have never smoked, e-cigarettes are attracting very few young people who have never smoked into regular use...and do not appear to be undermining the long-term decline in cigarette smoking in the UK among young people,' the review stated.

Although never smokers who try e-cigarettes are more likely to have tried smoking subsequently than those who do not, PHE found that ‘a causal link has not been established and neither has progression to regular smoking'.

‘The “common liability” hypothesis seems a plausible explanation for the relationship between e-cigarettes and smoking implementation,’ the report said.

PHE found that because there is little to no difference in the biomarkers of those who smoke and vape compared with cigarette-only smokers, dual users should continue to be encouraged and supported to stop smoking altogether.

The most worrying finding of the review, according to PHE, is that the proportion of the public who believe e-cigarettes are at least as dangerous as smoking continues to rise, reaching 26% of adults last year. And the same trend is seen among smokers.

'This is of serious concern given the strong correlation between perceptions of harm from e-cigarettes and a decreased likelihood of trying vaping,' PHE said.

Shirley Cramer CBE, chief executive of the Royal Society for Public Health, said: 'The past few years has seen a growing and welcome consensus on vaping among the UK health community, with prestigious organisations such as the Royal College of Physicians, Royal College of General Practitioners, and British Medical Association all joining in recognition of the public health potential of e-cigarettes. PHE’s new evidence review further strengthens this consensus.

'Nonetheless, with many smokers now incorrectly believing vaping is at least as dangerous as smoking, it is clear there is vital work to be done in better communicating these positive messages to the public. For anyone who has struggled to quit smoking, we strongly recommend switching to an e-cigarette as it could substantially improve your chances of success – especially if combined with professional support from your local stop smoking service.'