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Fresh welcomes PHE's 2021 vaping report

FRESH and a respiratory doctor from the North East have welcomed a major new national report which highlights how vaping could help people quit smoking.


At a time when the number of vapers in England is levelling off, incorrect perceptions of relative risks of vaping compared to smoking could be discouraging smokers from trying a vaping product to quit.


Public Health England's seventh independent report on vaping in England,, carried out by researchers at King's College London, is published this week. It found:


  • Nicotine vaping products were the most popular aid (27.2%) used by smokers trying to quit in England in 2020.
  • It is estimated that in 2017 over 50,000 smokers stopped smoking with the aid of a vaping product who would otherwise have carried on smoking.
  • 38% of smokers in 2020 wrongly believed that vaping is as harmful as smoking and 15% believed that vaping is more harmful.
  • Using a vaping product as part of a quit attempt in local stop smoking services had some of the highest quit success rates (between 59.7% and 74% in 2019-20).


Separate from the PHE report, estimates for the North East in 2020  suggested around 154,000 people were vaping compared to around 169,000 in 2019 – a slight fall.


The report takes an in depth look at the latest evidence on the effectiveness of nicotine vaping products in helping people to stop smoking. The report also provides an update on the use of nicotine vaping products among young people and adults and examines the data on people's perception of risk.


Dr Ruth Sharrock, Consultant Respiratory Physician and clinical lead on tobacco for the North East and North Cumbria Integrated Care System, said: "I see the devastating impacts of smoking on people's health every day; COPD, emphysema and lung cancer. Stopping smoking gives them the best chance to improve their health and experience better responses to treatments, so I offer support with whichever strategy will work for them. For some that is with nicotine replacement products, some prefer to use tablets to break the addiction. For others, switching to vaping is an alternative that feels very similar to smoking and can provide the same 'hit' but with a vastly reduced risk of harm.


"A lot of smokers are nervous about considering e-cigarettes, feeling that there may be associated risks and I have to help put this in the context of the proven harms and life-limiting diseases caused and accelerated by smoking. As health professionals, being able to help a smoker convert to vaping is an invaluable tool in our armoury towards reducing the harms caused by tobacco dependence."


Ailsa Rutter OBE, Director of Fresh, said: "We welcome this report which adds to both the evidence and feedback from ex-smokers that switching over completely to vaping can help people to successfully quit.


"We are however concerned that some smokers are being scared off from trying vaping from misperceptions about relative harm or might stop because they aren't sure how to maximise their potential.  The time has come for all health care professionals in particular to provide accurate information to smokers about the risks of continuing to smoke and to positively encourage them to stop including trying vaping as part of their options.


"One in two smokers who don't quit will die from smoking tobacco and smoking remains the key driver of health inequalities. We must do all we can to help reduce rates across all groups, and that should include the role of harm reduction."


In England in 2020, nicotine vaping products were the most popular aid used by smokers trying to quit with 27.2% of smokers using a vaping product compared with 18.2% using nicotine replacement therapy (NRT) products such as patches and gum and 4.4% using the prescription medicine varenicline.


Evidence over the years suggests that as the use of vaping products in quit attempts increases, the number of successful quits in England also increases. It is estimated that in 2017 over 50,000 smokers stopped smoking with the aid of a vaping product who would otherwise have carried on smoking.


Data from systematic reviews since PHE's 2018 report show that vaping products were significantly more effective for helping people stop smoking than NRT. Those using a vaping product as part of their quit attempt in local stop smoking services have some of the highest quit success rates (between 59.7% and 74% in 2019-20).


Vaping has plateaued in adults and young people since the last PHE report (March 2020).  Around 4.8% of young people (aged 11-18 years) reported vaping at least once a month, the same as last year, and most of these were either current or former smokers (only 0.8% of young people who had never smoked currently vape).


Smoking prevalence among young people (including those who smoked sometimes or more than once a week) was 6.7% in March 2020, similar to March 2019 (6.3%). The law bans the sale of smoking and vaping products to under 18s but age of sale violations are being reported.


Similar to last year, around 6% of adults are current vapers, equating to about 2.7 million adult vapers in England. Smoking prevalence continues to fall and is between 13.8% and 16% depending on the survey. Vaping prevalence was between 17.5% and 20.1% among current smokers, around 11% among former smokers and between 0.3% and 0.6% among never smokers. The proportion of vapers who also smoke ("dual users") has declined since 2012.


There are still concerns around increasing misperception of the relative risk caused by vaping products compared to smoked tobacco. In 2020, 38% of smokers believed that vaping is as harmful as smoking and 15% believed that vaping is more harmful. This is out of line with expert reviews from the UK and US concluding that using regulated nicotine vaping products is far less harmful than smoking.


PHE's advice remains that smokers should switch to vaping products to help them quit smoking, but non-smokers should not take up vaping. Vaping products contain significantly less harmful chemicals than cigarettes but are not without some risks.


Professor John Newton, Director of Health Improvement at Public Health England, commented on the report:"Smoking is still the leading preventable cause of premature death and disease – killing almost 75,000 people in England in 2019. The best thing that a smoker can do is to stop smoking completely and the evidence shows that vaping is one of the most effective quit aids available, helping around 50,000 smokers quit a year."


Professor Ann McNeill, Professor of Tobacco Addiction at King's College London, and lead author of the report said: "Our report draws together findings from randomised controlled trials, stop smoking services and population studies and concludes that nicotine vaping products are an effective way of successfully quitting smoking.


"What is concerning is that smokers, particularly those from disadvantaged groups, incorrectly and increasingly believe that vaping is as harmful as smoking.  This is not true and means fewer smokers try vaping."




The full 2021 report:


The full collection of PHE ecig reviews:


The Tobacco Control Plan for England:


Tobacco and Related Products Regulations 2016:


UCL Smoking Toolkit Study:


ASH YouGov Smokefree GBAdult Survey2020:


ONS Opinions and Lifestyle Survey 2019:


ASH YouGov Smokefree GB Youth Survey 2020:


NHS Digital Statistics on NHS Stop Smoking Services in England, April 2019 to March 2020:


NHS Digital Statistics on Smoking, England 2020: