Action on Smoking and Health

Tag Archives: Public Health England

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. [1] 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%. [2]

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.” [3]

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.[4] 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.” [5]


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: 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.


[1] 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.

[2] The latest YouGov survey can be downloaded from:

[3] National Academies of Science, Engineering and Medicine. Public Health Consequences of E-Cigarettes 23 January 2018. The US report can be downloaded from The quote included in the press release comes from the summary. Section 19-4 page 500 goes into more detail:

“E-cigarette Harm

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.”

[4] ONS Adult smoking habits in the UK: 2016. Published June 2017.

[5] DH. Tobacco Control Plan for England. July 2017.

England one of the best places in the world to quit smoking this October

21 September 2017 

As the annual Stoptober campaign to encourage smokers to quit is launched, ASH confirms that England is one of the best places to try to give up.

The UK consistently tops the European rankings for tobacco control policy [1] and smoking prevalence has been steadily falling for several years. [2] At a global level, the World Health Organisation recognises the UK as a world leader in tobacco control. [3]

There are a number of policies in place to encourage smokers to kick the habit. In the ten years since the ban on smoking in public places was introduced in England in 2007, there are almost two million fewer smokers. [4] Support for the smoking ban is stronger than ever, especially among smokers themselves. [5] Electronic cigarettes have had a significant impact, too. 2.9 million adults in England currently use electronic cigarettes, primarily to help them quit and to prevent them from relapsing back to smoking. [6]

While England continues to make great progress towards a smokefree generation, the vision of the government’s tobacco control plan [7], we must not become complacent. There needs to be continued access to support for quitting all year round in order for us to beat the tobacco epidemic once and for all.

Evidence shows that the most effective way to quit smoking is through a combination of professional face to face support and stop smoking aids, such as nicotine patches, gum, or electronic cigarettes. This approach has been shown to be four times more effective than trying to quit without aids or support. [8]

Hazel Cheeseman, ASH Director of Policy, said:

“With the help of Stoptober there has never been a better time to try to quit smoking. We know that smokers find e-cigarettes helpful in quitting so it’s great that Stoptober is encouraging their use for the first time this year.”



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:

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 on 020 7404 0242 or out of hours Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.


[1] L Joossens, M Raw, The Tobacco Control Scale 2013 in Europe. Brussels, 2014.

[2] Statistics on Smoking in England 2017. NHS Digital, June 2017.

[3] World Health Organisation report on the global tobacco epidemic 2017.

[4] Cancer Research UK press release: British smokers down by 1.9 million since the ban. 1 July 2017.

[5] ASH report Smokefree: The First Ten Years. London, July 2017.

[6] ASH factsheet: Use of e-cigarettes among adults in Great Britain 2017.

[7] Towards a smoke-free generation: tobacco control plan for England. Department of Health, 2017.

[8] Public Health England website –

Stoptober: ASH calls for more mass media campaigns to help smokers to quit

20 September 2016

In advance of the annual Stoptober stop smoking campaign, ASH is calling on the Government to increase the frequency and the amount of money spent on stop smoking campaigns.

Deborah Arnott Chief Executive of ASH said,

“ASH strongly supports Stoptober which provides the support and encouragement that we know most smokers need to help them stop.  However, we are very concerned about the recent announcement by the Health Minister in the Lords that funding for mass campaigns like Stoptober has been cut again this year. The evidence is clear, to be successful mass media campaigns need to run throughout the year; Stoptober alone is not enough.”

During a parliamentary debate, the Health Minister, Lord Prior said that the expenditure allocated for this financial year was £4 million.*  Last year it was £5.3 million and it has declined significantly in the last 6 years; in 2008-09 it was nearly £25 million.

Financial year[1] Media Spend (£m)
2008-09 23.38
2009-10 24.91
2010-11 0.46
2011-12 3.16
2012-13 8.21
2013-14 7.64
2014-15 6.92
2015-16 5.3


ASH is also calling on the Government to publish without delay its new Tobacco Control Plan, replacing the previous one which expired at the end of 2015.  The new plan needs to clearly set out how the Government intends to fund tobacco control including mass media campaigns and Stop Smoking Services.


Contact:   Deborah Arnott 020 7404 0242 (w) or 07976 935 987 (m)

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:

ASH receives core funding from Cancer Research UK and the British Heart Foundation.

* Hansard. HoL Debate.  Lord Prior of Brampton:  “£4 million has been allocated for tobacco-specific marketing activities, £1 million of which is for the Stoptober campaign launching next month.”


Effectiveness of Mass media campaigns


  1. Research has shown that mass media campaigns are highly effective and cost-effective in motivating quit attempts and discouraging uptake of smoking.[i] However, the UK is currently falling far below best practice spending on mass media campaigns.


  1. In 2009 funding for anti-smoking mass media campaigns in England was just under £25 million: by 2015 this figure had been cut to only £5.3 million, with further cuts expected this year. If England were to fund mass media campaigns at levels recommended by the US Centers for Disease Control and Prevention, it should have been spending around £60 million; more than ten times the amount spent in 2015.[ii]


  1. Studies carried out in England in the past few years have found that mass media campaigns have been effective in triggering quit attempts and have been responsible for a significant proportion of the reduction in smoking prevalence,[iii] and that the freeze on mass media campaigns at the time of the 2010 election was associated with a reduction in quitting activity.[iv] A systematic review of economic evaluations of mass media campaigns noted that all of these found mass media campaigns to be cost effective[v], but these campaigns need to have sufficient intensity and be sustained in order to have a meaningful effect.[vi]


  1. A 2016 regional mass media campaign conducted by Fresh North East and Smokefree Yorkshire and Humber illustrates the value of mass media in promoting quit attempts. The campaign which focused on 16 cancers caused by smoking, reached approximately 333,000 people via TV, radio, print and online. Of those who saw the campaign 16% (around 55,300 people) cut down on their smoking. A further 8.4% (around 28,000 people) made a quit attempt as a result of the campaign while 4% switched to electronic cigarettes. This shows the clear impact mass media campaigns have on triggering quit attempts and changes in behaviour.



[i] Langley T. et al. The impact of media campaigns on smoking cessation activity: a structural vector autoregression analysis, Addiction 2012, 107(11):2043-50. 

[ii] Hopkinson NS, Millett C, Glantz S, Arnott D, and McNeill A (2016) UK government should fund stop smoking media campaigns not give tax breaks to films with smoking imagery. Addiction. doi: 10.1111/add.13511

[iii] Sims M, Salway R, Langley T. et al.. Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study Addiction. 2014 109 (6): 986-94

[iv] Langley T, Szatkowski L, Lewis S et al. The freeze on mass media campaigns in England: a natural experiment of the impact of tobacco control campaigns on quitting behaviour.  Addiction 2014: 109: 995-1002

[v] Atusingwize E, Lewis S, Langley T. Economic evaluations of tobacco control mass media campaigns: a systematic review  Tobacco Control 2015: 24: 320-327

[vi] Durkin S & Wakefield M.  Commentary on Sims et al. (2014) and Langley et al. (2014) Mass media campaigns require adequate and sustained funding to change population health behaviours.  Addiction 2014: 109: 1003-1004.

ASH response to consultation on Public Health England

ASH response to a consultation on Public Health England.