The under-use of vapes is a “large, missed opportunity to reduce morbidity and premature mortality,” a major new report warns.
The report E-cigarettes and harm reduction: An evidence review, by the Royal College of Physicians, looks at how vapes can effectively support more people to quit smoking while at the same time discouraging young people and non-smokers from taking them up.
Smoking causes eight million deaths globally every year, with two out of three people who continue to smoke dying from a smoking-related disease.
The report says: “Using e-cigarettes for harm reduction to reduce morbidity and mortality from combustible tobacco is based on clear evidence that e-cigarettes cause less harm to health than combustible tobacco.
“It is important to provide users of e-cigarettes with as much accurate data as possible on the relative and absolute health effects of e-cigarettes in comparison to use of combustible tobacco alone, dual use and never smoking.”
Effectiveness of vaping in helping smokers quit
The RCP report quotes evidence from randomised controlled trials and from two Cochrane reviews, which shows e-cigarettes with nicotine are more effective at helping people quit smoking at six months or longer than nicotine replacement therapy (NRT).
Among pregnant women who smoke, the largest randomised trial to date shows the same quit success for e-cigarettes as NRT and a lower frequency of low birthweight in babies among expectant mothers using e-cigarettes.
The report says that vapes may also help people with mental illness to quit smoking - including those with no motivation to do so, or who have been unable to before. It adds that vape starter kits have been effective in stopping people smoking in prisons, social housing and emergency departments.
Therefore, the report concludes, vapes have a “positive role to play in reducing smoking-related health inequalities.”
Recommendations
The RCP report says that vapes should be more effectively marketed to people wanting to quit smoking. It includes recommendations to:
- add reduced risk messages to cigarette packs to focus on getting smokers to switch over to vapes;
- ensure access to a variety of flavours to encourage uptake of e-cigarettes for smokers to quit;
- ensure trained specialists are available in all healthcare settings to offer support for smoking cessation using vapes;
- focus vaping campaigns on those who are likely to experience the most benefits, including smokers with mental disorders, the most socio-economic disadvantaged and people living in social housing, thereby reducing smoking related health inequalities;
- look at trends in smoking to vaping transitions to inform local tobacco control;
- sufficiently resource Trading Standards to effectively enforce e-cigarette sale legislation and reduce underage sales;
- introduce a retail licensing scheme to reduce access to e-cigarettes amongst young people.
Despite concerns over vaping’s appeal to young people, the report says it is still “overwhelmingly an activity of smokers and ex-smokers, who represent around 93 per cent of all people who use vaping products.”
John Dunne, director general of the UKVIA, welcomed the report, saying: “It is clear that the RCP sees a major public health prize in vaping and it’s up to the industry, regulators, enforcement bodies and policy makers to ensure that this is fully realised; and that e-cigarettes do what they do best and help the remaining smokers in the UK give their habits up in the coming years and enable the government to achieve its smoke free ambition.”
