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Vaping and Tobacco Harm Reduction

E-cigarettes, also known as vapes or ENDS (Electronic Nicotine Delivery Systems) deliver nicotine in non-combustible form, are much less harmful to health than smoking and have been shown to be nearly twice as effective as nicotine replacement therapies, such as patches and gum, when used in a Stop Smoking Service setting.

Tobacco harm reduction encouraging adult smokers to use e-cigarettes is supported by the UK Government, the MHRA and NICE, as well as by leading UK health organisations including ASH. The UK’s regulatory approach is to encourage their use for quitting while minimising the risk of any new nicotine addiction in children.

Use of e-cigarettes by adults and youth

ASH monitors adult and youth use of e-cigarettes in its annual online Smokefree GB adult and youth surveys, conducted by YouGov. These enable us to review whether regulation is effective in achieving the goal of encouraging adult smokers to switch to vaping while minimising the risks of youth use:

Addressing common myths about vaping: Putting the evidence in context

A myth-busting briefing on vaping, including references to inaccurate reporting in the press. Available here.

Policy options to tackle the issue of disposable (single use) vapes

Disposable vapes are single use plastic devices containing a lithium battery, which are commonly used for only a day or so before being discarded, with inadequate recycling. This paper by Action on Smoking and Health (ASH), the Chartered Trading Standards Institute (CTSI) and Material Focus sets out the problems being caused by disposable vapes, policy options for addressing these, and how potential adverse unintended consequences could be mitigated.

Regulation of e-cigarettes

Electronic cigarettes are regulated in the UK as consumer products in line with the WHO FCTC decision FCTC/COP6(9). Medicinal licensing is an option, but there are currently no medicinally licensed products on the market. Without a medicinal licence, e-cigarettes cannot be marketed by the manufacturer for use for stopping smoking.

NICE guideline NG209 recommends that health and social care professionals identify people who smoke and “Offer advice on using nicotine-containing products on general sale, including over-the-counter nicotine replacement therapy (NRT) and nicotine-containing e-cigarettes.”

The Government publishes evidence on the impact of e-cigarettes, information on government policy and regulation, and guidance for organisations on vaping policies.

UK regulation of e-cigarettes is in line with the EU Tobacco Products Directive (2014/40/EU), and Canada and New Zealand have a similar approach, but many other countries either ban or regulate e-cigarettes more strictly.

Regulatory review

In 2021 the Government was required to review the Tobacco and Related Products Regulations which include e-cigarette regulations. The ASH and SPECTRUM response identified loopholes in the law which need to be addressed:

  • While sale to under 18s is prohibited, free distribution is not.
  • Regulation of e-cigarettes allows the use of packaging and labelling appealing to children such as sweet names, cartoon characters and garish colours

The Government post-implementation review response did not commit to address these loopholes.

Furthermore while the rules on enforcement are clear, there is a lack of capacity to deliver which needs to be addressed in the forthcoming Tobacco Control Plan for England.