E-Cigs: Concerns Over Harm May Be Hindering Smoking Quit Rates

Peter Russell

February 23, 2021

A misguided public perception that 'vaping' could be as hazardous to health as smoking tobacco could be discouraging smokers from trying a vaping product to help them quit, Public Health England (PHE) said.

A study carried out for PHE by researchers at King's College London (KCL) found that using a vaping product as part of a quit attempt had some of the highest success rates compared with other methods.

The seventh independent report on vaping in England examined the latest evidence on the effectiveness of vaping in helping people stop smoking. It also updated the use of nicotine vaping products among adults and young people and examined data on people's perception of risk.

Among the main findings were that:

  • Nicotine vaping products were the most popular quit smoking aid with 27.2% of smokers using them compared to 18.2% using nicotine replacement therapy (NRT) products, and 4.4% using the prescription medicine varenicline

  • In 2017, more than 50,000 smokers stopped smoking cigarettes using a vaping product

  • Using a vaping product as part of a quit attempt in local stop smoking services had a quit success rate of between 59.7% and 74% in 2019-20

Perception of Harm 'Concerning'

However, the report also found that 38% of smokers in 2020 believed that vaping was as harmful as smoking, while 15% believed that vaping was more harmful. That was out of line with experts in the UK and the US who supported regulated nicotine vaping products for causing less harm than smoking, PHE said.

Vaping rates had plateaued in adults and young people since the last report, researchers found.

Ann McNeill, professor of tobacco addiction at King's College London, and lead author of the report, said: "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."

Around 6% of adults in England were currently vaping, figures suggested, equating to about 2.7 million people – similar to last year.

Vaping prevalence was:

  • Between 17.5% and 20.1% among current smokers

  • Around 11% among former smokers

  • Between 0.3% and 0.6% among 'never smokers'

The proportion of vapers who also smoke – so called 'dual users' – has declined since 2012.

Smoking Rates Falling

Smoking prevalence in England has continued to fall and is between 13.8% and 16%, depending on the survey. That compared to 15.5% in 2016.

Around 4.8% of young people aged 11 to 18 reported vaping at least once a month, the same as last year. Most of those were either current or former smokers. Only 0.8% of young people who had never smoked currently vape, the study found.

Researchers said it was too early to assess the effect on vaping and smoking during the COVID-19 pandemic.

Professor John Newton, director of health Improvement at PHE, commented: "Smoking is still the leading preventable cause of premature death and disease – killing almost 75,000 people in England in 2019."

He said: "The evidence has been clear for some time that, while not risk free, vaping is far less harmful than smoking. For anyone who smokes, particularly those who have already tried other methods, we strongly recommend they try vaping and stop smoking, ideally with additional support from their local stop smoking service for the very best chance of quitting for good.

"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."

PHE has commissioned a full review from KCL of the evidence on the safety of vaping products, which will be published in 2022. 


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: