What can other countries learn from the United Kingdom’s attitude towards e-cigarettes?

By Pascal Culverhouse of the Electric Tobacconist

An exclusive column from Pascal Culverhouse for Spinfuel eMagazine

Compared to Australia, where buying or selling nicotine fluid is illegal, the UK’s laws on vaping are fairly relaxed. In fact, since Public Health England estimated that e-cigarettes are 95% less harmful than tobacco, a vaping product has been licensed for use by the National Health Service. What can other countries learn from the UK’s liberal approach?

E-cigarettes have puzzled and polarised public health officials around the globe. Some public health bodies, such as the FDA in the US, see e-cigarettes as a threat to be tightly regulated, while other organisations, such as Public Health England, recognise that e-cigarettes are a massive opportunity for harm-reduction. As a result, different countries have very different vaping laws, ranging from loose regulation in some places to outright bans in others.

These differing laws mean that we have a kind of natural experiment that we can observe and learn from. If e-cigarettes are a public health benefit, then countries like the UK which have more relaxed laws should be seeing some gains since they became popular in 2012. Conversely, if e-cigarettes are a public health hazard, then we should be seeing public health damage in the UK by now.

Has smoking health in England improved or deteriorated since 2012?

The UK has an estimated 2.6 million vapers. The most common reason that people try e-cigarettes for the first time is because they want to give up smoking. Of current vapers, one million have managed to avoid relapsing into smoking, while 1.4 million both smoke and vape (dual use). While critics see dual use as a negative, in fact dual users are exposed to less toxicants that smokers and report less severe symptoms of smoking-related illnesses. In addition, some of these dual users are forecasted to quit completely in time.

It has been found that e-cigarette users were more likely to quit successfully than those who go it alone and those who use over the counter nicotine replacement therapy products (patches and gums). In addition, nearly two-thirds of people who combined e-cigarettes with behavioural support managed to successfully quit.

Is vaping re-normalising smoking in the UK?

Crucially, there is no evidence that vaping is re-normalising smoking in the UK. In fact, as e-cigarettes have become more popular, smoking rates have fallen, and quit attempts have increased. There is also no evidence that there is a ‘gateway’ effect with e-cigarettes. A small number of young people do experiment with e-cigarettes, but in the vast majority of cases only smokers and ex-smokers go on to use e-cigarettes regularly. In England, there are no recorded instances of a young person without a history of smoking going on to start vaping daily (so far).

Critics of e-cigarettes often point out that there are a lot of things that we don’t know about e-cigarettes. But we know a lot of the most important things already — including the fact that where e-cigarette use is up, smoking is down and the fact that e-cigarettes remain unappealing to non-smokers. In summary, vaping has helped to reduce the number of smokers in the UK and despite fears, it has not lead to an increase in the number of young people smoking or non-smokers vaping. Even though many people do dual use e-cigarettes and cigarettes, this positive step can be viewed as part of a longer quitting and harm-reduction process.

By Pascal Culverhouse of the Electric Tobacconist