ASH welcomes new Public Health England Report on E-Cigarettes
6 February 2018
Action on Smoking and Health has strongly welcomed a new report on e-cigarettes, produced by independent experts for Public Health England.  The report updates the evidence on e-cigarette use among adults and young people; their effectiveness as an aid to quitting by smokers; the risks to health compared to smoking and public understanding of those risks. PHE goes on to urge smokers and public bodies to act on the evidence.
The report suggests that just under 3 million people currently use e-cigarettes, but that the numbers using them have now levelled off. E-cigarettes are likely to be helping at least 20,000 people to quit smoking every year. Those smokers who switch completely to vaping are likely to substantially cut health risks. The report concludes that the evidence does not support concerns that e-cigarettes are a route into smoking among young people. Youth smoking rates continue to decline, and regular vaping is negligible among young people who have never smoked.
However, the report raises serious concerns about public misunderstanding of the risks and benefits of e-cigarette use. Millions of smokers wrongly think that vaping is as harmful as smoking. Around 40% of current smokers have never tried e-cigarettes. And fewer than one in ten adults know that most of the health damage caused by smoking comes from the by-products of cigarette combustion, and not from the nicotine content.
These findings support the evidence from successive YouGov surveys commissioned by ASH. Between 2013 and 2017 a growing proportion of both the general public and smokers failed to recognise that e-cigarette use is much less harmful than smoking. In 2017 only 13% of adults correctly identified that e-cigarettes are much less harmful, compared to 21% in 2013. The proportion of adults thinking that e-cigarettes are at least as dangerous as smoking nearly quadrupled from 2013 to 2017 from 7% to 26%. 
The PHE report follows a recent report by the US National Academies of Sciences, Engineering and Medicine, which concluded that “e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.” 
Commenting, ASH Chief Executive Deborah Arnott said:
“The PHE report is part of a growing scientific consensus that e-cigarettes are likely to be very much less harmful than smoking and can help smokers quit. E-cigarette use has stagnated in recent years, which is hardly surprising as many smokers incorrectly believe that vaping is as harmful as smoking. We hope this report will provide the reassurance needed to encourage the 40% of smokers who’ve failed to quit but never tried vaping to go ahead and switch.
She went on to say:
“ASH supports PHE’s recommendation that smokers who have struggled to quit should try vaping as an alternative to smoking, and that e-cigarettes should be made available on prescription. Smoking remains the leading cause of preventable premature death, responsible for over 1,000 hospital admissions a day in England. Providing support to smokers to quit is highly cost-effective and essential for the sustainability of the NHS.”
In order to be provided on prescription e-cigarettes have to be licensed as a medicine by the MHRA. The Tobacco Control Plan for England makes a commitment to “maximise the availability of safer alternatives to smoking”, and it goes on to say that, “The Medicines and Healthcare products Regulatory Agency (MHRA) will ensure that the route to medicinal regulation for e-cigarette products is fit for purpose so that a range of safe and effective products can potentially be made available for NHS prescription.” 
Notes and Links
Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see: www.ash.org.uk/about-ash. ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.
ASH staff are available for interview and have an ISDN line.
For more information contact ASH: 020 7404 0242, or out of hours, Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.
 The evidence review was conducted for Public Health England by Professor Ann McNeill, Professor of Tobacco Addiction at King’s College, and Professor Linda Bauld, Professor of Health Policy at the University of Stirling.
 The latest YouGov survey can be downloaded from: http://ash.org.uk/download/use-of-e-cigarettes-among-adults-in-great-britain-2017/
 National Academies of Science, Engineering and Medicine. Public Health Consequences of E-Cigarettes 23 January 2018. The US report can be downloaded from https://www.nap.edu/catalog/24952/public-health-consequences-of-e-cigarettes. The quote included in the press release comes from the summary. Section 19-4 page 500 goes into more detail:
As concluded in previous chapters, e-cigarettes are likely to be less harmful than combustible tobacco cigarettes. Estimates of how harmful they are relative to combustible tobacco cigarettes range from 5 percent estimated by the U.K. Royal College of Physicians (TAG, 2008) to 30 to 50 percent estimated by Glantz (2016), with most agreement concentrated around the lower figure.”
 ONS Adult smoking habits in the UK: 2016. Published June 2017.
 DH. Tobacco Control Plan for England. July 2017.