Vaping and tobacco harm reduction - highlights from England

On this page, I set out some of the good things on tobacco harm reduction that have come from England. Updated February 2020.

1. National government policy statements (England)
2. Realistic science
3. Practical professional guidance and public communications
4. Reasonable public health consensus statements and policy positions
5. Useful data
6. Engaged consumers
7. Groundbreaking conferences
8. Forthright commentators
9. Engaged trade associations

1. National government policy statements (England)

Pro-harm-reduction national policy statements…

• Prevention Green Paper (consultative): Advancing our health: prevention in the 2020s. July 2019. Consults on Smoke-free England 2030 goal and mentions an “ultimatum for industry to make smoked tobacco obsolete by 2030, with smokers quitting or moving to reduced-risk products like e-cigarettes”.
• Vision for prevention in public health: Prevention is better than cure, 5 November 2018
• Tobacco control delivery plan: Tobacco control plan: delivery plan 2017 to 2022, 7 June 2018.
• Tobacco Control Plan for England: Towards a smoke-free generation: tobacco control plan for England(PDF) – 18 July 2017
• Blog focussed on harm reduction aspects of the Tobacco control plan for England: English tobacco control plan embraces tobacco harm reduction – world first– 18 July 2017

With support in Parliament

• All-Party Parliamentary Group on Smoking and Health, Delivering the vision of a ‘Smokefree Generation’, February 2019.
• House of Commons Select Committee on Science and Technolgy: Report on E-cigarettes, 17 August 2018. (see more detail on this extensive inquiry below)

2. Realistic science

Significant scientific assessments

• Public Health England (2019): Vaping in England – an evidence update, February 2019. Press release / Executive summary / Report / Blog by Martin Dockrell
• Public Health England (2018): Evidence review of e-cigarettes and heated tobacco products 2018 Press release /Report page/ Executive summary(20 pages) / Report PDF (243 pages) / Q&A blog/ Ann McNeill video/ Training resources /Lancet editorial/ BMJ

“Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know”

• Public Health England (2015): E-cigarettes: an evidence update, August 2015 – and press release E-cigarettes around 95% less harmful than tobacco estimates landmark review. See also: authors’ note on the claim that vaping is 95% lower risk than smoking, and my discussion: PHE says truthful, realistic things about e-cigarettes and critique of its critics, Smears or science.
• Public Health England (2014): Electronic cigarettes: reports commissioned by PHE, May 2014.
• Royal College of Physicians (2016) – Nicotine without smoke: tobacco harm reduction, April 2016 – and press release. Landmark quote:

“Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure“. (Section 5.5 page 87)

For a discussion of key quotes from this document, see my submission to the Government of Ireland: Vaping and tobacco harm reduction in Ireland – consultation response in five quotes– February 2017. For a PowerPoint that uses these quotes – see Slideshare.

• UK Centre for Alcohol and Tobacco Studies: Commentary on WHO report on ENDS, October 2016. A blistering critique of WHO’s vaping science.
• Food Standards Agency, Independent Committee on Toxicology. Statement on heat-not-burn tobacco products, 11 December 2017.
• British Psychological Society: Changing behaviour – electronic cigarettes, October 2017
• Dr. Lynne Dawkins, South Bank University – E-cigarettes: an evidence update – all on a guest blog. Myth busting lecture on the science of vaping (slides). November 2018.

Collaborative research approach

• Cancer Research UK, UKCTAS, Public Health England, UK research councils: UK Electronic Cigarette Research Forum

3. Practical professional guidance and public communications

On quitting smoking for professionals…

• National Centre for Smoking Cessation and Training;
  • E-cigarettes: a guide for healthcare professionals, February 2018
  • Electronic cigarettes: A briefing for stop smoking services, February 2016
• National Institute for Health and Care Excellence (NICE): Stop smoking interventions and services – guideline NG92. / Press release. March 2018.
• National Health Service (NHS) advice: Smokefree NHS – Advice on E-cigarettes
• Leicester (Louise Ross) Leicester Stop-smoking Service – an e-cig friendly service
• Smokefree Action: Smoking in Pregnancy Challenge Group– includes: Use of electronic cigarettes in pregnancy: A guide for midwives and other healthcare professionals with Infographic
• Royal College of Midwives. Position statement: Support to quit smoking in pregnancy, May 2019.

Public-facing communications

• National Health Service Smokefree campaign – information on e-cigarettes– (December 2018) linked to…
• PHE public information video (below) with basics on why vaping is so much safer than smoking – and related BBC coverage.

• NHS “Live Well” advice: Using e-cigarettes to stop smoking
• NHS “One You” campaign: Using e-cigarettes / vapes to quit smoking
• Stoptober: The annual government-backed stop-smoking campaign Stoptober embraced e-cigarettes in October 2017 – see BBC Quit smoking campaign Stoptober backs e-cigs for first time
• The Switch – inspiring video accounts of real vapers talking about quitting smoking
• Say why to drugs podcast e-cigarette edition – Professor Linda Bauld and Dr. Suzi Gage discuss e-cigarettes, why UK and US are different, Juul and much else (January 2019)

On smoke-free policy…

These reflect the view that vaping policy should be a matter for the owner or manager of the premises, not subject to a blanket legal ban.

• Public Health England. Use of e-cigarettes in public places and workplaces including Advice on evidence-based policy-making (PDF) and a 5-point guide to policymaking on this issue.
• Action on Smoking and Health. Will you permit or prohibit e-cigarette use on your premises? October 2015

On e-cigarette advertising

These very sensible industry codes govern the advertising that is not banned by the wholly disproportionate EU Tobacco Products DirectiveArticle 20(5) as it applies in the UK.

• Committee on Advertising Practice: E-cigarettes: Non-broadcast Code Section 22 / Broadcast Code Section 33
• Committee on Advertising Practice: Claims about health in e-cigarette advertising– this allows for truthful health statements to be made in e-cigarette ads.

4. Reasonable public health consensus statements and positions

Cabinet Secretary (Head of UK civil service)

Blog by Sir Jeremy Heywood: How the Nudge unit threw light on lighting up2015

Consensus statement

2016 statement by Public Health England, Action on Smoking and Health, Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Healthier Futures, Public Health Action (PHA), Royal College of Physicians, Royal Society for Public Health, UK Centre for Tobacco and Alcohol Studies, UK Health Forum

• E-cigarettes: a developing public health consensus, July 2016
• E-cigarettes: an emerging consensus, September 2015

Individual organisations and people

• Public Health England – blogs giving e-cigarette positions
• Cancer Research UK: Our policy on e-cigarettes, 2016. Full position: Briefing, Q&A,
• Action on Smoking and Health: ASH Briefing on E-cigarettes, 2016
• Royal College of General Practitioners with Cancer Research UK: Position Statement on the use of electronic nicotine vapour products (Sept 2017)with a podcast and video (see below).
• British Medical Association: E-cigarettes: balancing risks and opportunities (substantially updated in Nov 2017)
• Royal Society for Public Health: Smoking cessation and e-cigarettes
• British Heart Foundation: E-cigarette policy
• British Lung Foundation: E-cigarette policy
• PHE official Martin Dockrell blogs about tobacco harm reductions on Public Health Matters

Jim McManus, Director of Public Health, Hertfordshire: How and why I changed my mind on e-cigarettes, with Kevin Fenton (PHE): Hertfordshire e-cigarette policy aims to help smokers quit Hertfordshire County Council: E-cigarette policy announcement, 2016 – Policy (PDF)

Professor Ann McNeill, the lead author of 2018 Public Health England E-cigarette evidence review, discussing the review:

UK experts talking sense about vaping and harm reduction – on video (Ann McNeill, John Britton, Robert West, Deborah Arnott, Ian Gray) and see many of the same experts on The Switch (2017) below:

Professor Linda Bauld of Cancer Research UK and Dr Richard Roope of Royal College of General Practitioners and CRUK Cancer Clinical Champion, addressing key concerns that GPs have voiced about e-cigarettes.

UK Parliamentary inquiry – December 2017 – December 2018

The House of Commons Select Committee on Science and Technology inquiry into e-cigarettes took evidence in December 2017. See:

• All evidence submitted
• Committee report (PDF)
• Government response to recommendations (December 2018)

Some highlights from the submitted evidence.

• Oral testimony
• Public Health England
• University College London, Tobacco and Alcohol Research Group (West, Brown, Shabab)
• ASH UK
• Royal College of Physicians
• British Heart Foundation
• Cancer Research UK
• Royal Society for Public Health
• British Medical Association
• Cochrane group
• UK Centre for Tobacco and Alcohol Studies
• National Institute for Health and Care Excellence (NICE)
• Smoking in Pregnancy Challenge Group
• Mental Health and Smoking Partnership
• New Nicotine Alliance
• Department of Health (England)
• Peter Hajek
• Caitlin Notely, Lynne Dawkins, Emma Ward and Richard Holland
• Leicester City Council (Louise Ross)
• Independent British Vape Trade Association
• Institute for Economic Affairs

My contribution and a better-formatted version here

5. Useful data

• Office for National Statistics & Public Health England.Adult smoking habits in the UK Statistical bulletins (reports and analysis – annual – July)
• Office for National Statistics. Smoking habits in the UK and its constituent countries (data – annual – July)
• Office for National Statistics. E-cigarette use in Great Britain (data – annual – July)
• Smoking in England: Smoking Toolkit Survey: latest statistics/ all documents (monthly tracking, contains e-cigarette data)
• data.gov.uk. Statistics on smoking in England
• Public Health England: Local tobacco control profiles for England – (updated annually – July)
• ASH Fact sheets (current menu) – check for current data. ASH Briefings (current menu / Electronic cigarettes)
  • ASH / YouGov survey: Use of electronic cigarettes (vapourisers) among adults in Great Britain (2018)
  • ASH / YouGov survey: Use of electronic cigarettes (vapourisers) among children in Great Britain (2018)
• Commentary on 2018 data: Duncan Selbie, Turning the Tide on Tobacco: smoking in England hits an all-time low.  Public Health Matters blog, Public Health England, 3 July 2019.

6. Engaged consumers

• New Nicotine Alliance – consumer advocacy group
• Vapers.org.uk – with excellent daily news digest
• Vapers in Power (blog) – political movement
• The Switch – vapers talking about their experience of vaping

7. Groundbreaking conferences

• The E-cigarette Summit (annual in London since 2013) and since 2016 in the United States
• Global Forum on Nicotine (annual in Warsaw)
• PHE National Symposium on e-cigarettes, 2014

8. Forthright commentators

• Nicotine Science and Policy
• Velvet Glove, Iron Fist – Chris Snowdon
• Dick Puddlecote
• New Nicotine Alliance blog
• Planet of the Vapes (UK)
• Vapers in Power blog
• Facts do matter – vaping – Paul Barnes
• The Counterfactual by me.

9. Engaged trade associations

• UK Vaping Industry Association (UKVIA)
• Independent British Vape Trade Association (IBVTA)

And finally… even the (disgraced) former Prime Minister had something to say about it:

Please add suggestions for additions (with links please) in the comments…