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PHE e-cigarette review 2019 - Fresh calls for more acceptance in the NHS

Fresh has welcomed a new report on electronic cigarette use in Britain. It shows less than one in 50 under 18s are regular vaping, and most adult vapers are using their devices to try to quit smoking.


Weekly vaping among young people remains low in Britain and has plateaued among adults, the independent report "Vaping in England: An evidence update February 2019"  led by researchers at King's College London and commissioned by Public Health England (PHE) has found.


While experimentation with e-cigarettes among young people has increased in recent years, regular use remains low. Only 1.7% of under-18s use e-cigarettes weekly or more and the vast majority of those also smoke. Among young people who have never smoked, only 0.2% use e-cigarettes regularly.


Regular e-cigarette use among adults has plateaued over recent years and remains largely confined to smokers and ex-smokers, with quitting smoking the main motivation for adult vapers.


But despite e-cigarettes now being the most popular quit aid, just over a third of smokers have never tried one. Only 4% of quit attempts through Stop Smoking Services in England are made using e-cigarettes, despite this being an effective approach. The report recommends that Stop Smoking Services should do more to encourage smokers that want to quit with the help of an e-cigarette.


Ailsa Rutter OBE, Director of Fresh, said: "Tobacco smoking will kill at least one in two long term smokers. By contrast vaping is estimated to carry a fraction of the risk, and unlike tobacco and there is no evidence of any secondhand harm to bystanders.


"If more smokers switched completely to vaping we could see a significant reduction in premature deaths and life limiting diseases caused by tobacco. At a time when NHS Trusts and GPs are being encouraged to do more to treat tobacco dependency, we should be re-assured about the role e-cigarettes can play to improve the health of patients and give them the best chance of quitting for good.


"Electronic cigarette products are now the country's most popular quitting aid, and we need to support anyone using them to stay tobacco free."


Dr Chris Tasker, CRUK Strategic GP for the Northern Cancer Alliance, said: "There is still a lot of confusion surrounding vaping as many people believe it is as harmful as smoking, when in fact vaping poses much lower risks to someone's health. I regularly get asked questions by my patients – is vaping safe? Is it safer than smoking? My response to them is that smoking is the worst thing you can do for your health and vaping is much less harmful. Lots of my patients who've had trouble trying to quit for years and years, have managed to stop with the help of an e-cigarette.


"The advice I give my patients is that stopping smoking is the best thing they can do for their health. There are much fewer chemicals in vaping than in cigarettes, so it is far less harmful than smoking and can be helpful to people who might otherwise struggle to quit."






 The report says that combining e-cigarettes with face-to-face support should remain a recommended option available to all smokers. It calls for stop smoking practitioners and health professionals supporting smokers to receive education and training in the use of e-cigarettes in quit attempts. Online training is now available via NCSCT.




Professor John Newton, Health Improvement Director at Public Health England, said: "In contrast to recent media reports in the US, we are not seeing a surge in e-cigarette use among young people in Britain.


"While more young people are experimenting with e-cigarettes, the crucial point is that regular use remains low and is very low indeed among those who have never smoked. We will keep a close watch on young people's vaping and smoking habits to ensure we stay on track to achieve our ambition of a smoke-free generation."


Smoking rates in young people have plateaued in recent years, while smoking rates among adults continue to fall with just under 15% of adults in England smoking, according to government figures.


A major UK clinical trial, published recently and not included in this PHE report, has found e-cigarettes, when combined with face-to-face support, to be up to twice as effective for quitting smoking as other nicotine replacement products such as patches or gum.


Professor Newton also commented: "We could accelerate the decline in smoking if more smokers switched completely to vaping. Recent new evidence clearly shows using an e-cigarette with Stop Smoking Service support can double your chances of quitting. But with e-cigarettes currently used so rarely in services, it's time for change. Every Stop Smoking Service must start talking much more about the potential of vaping to help smokers quit."


Professor Ann McNeill, Professor of Tobacco Addiction at King's College London, lead author of the report said: "We are encouraged that regular vaping among young people in Britain who have never smoked remains low. However, we need to stay vigilant and in particular closely monitor youth smoking.


"With just over a third of adult smokers having never tried an e-cigarette, there is a clear opportunity for more smokers to try a method which has helped many others to quit. Smokers should be advised to stop smoking as soon as possible and explore all available options for support, including e-cigarettes."


The report is the first in a new set of three commissioned by PHE under the Government's Tobacco Control Plan for England. It looks specifically at use of e-cigarettes rather than health impacts, which will be the subject of a future report.