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Expert review backs positive potential of e-cigarettes


Electronic cigarettes are significantly less harmful to health than tobacco and have the potential to be a ‘game changer’ in helping smokers quit, a review of the available evidence by experts has concluded.

The findings from the review, published today by Public Health England, said the “current best estimate” was that e-cigarettes were around 95% less harmful than smoking.

There is also no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers, it said.

“The evidence consistently finds that e-cigarettes are another tool for stopping smoking”

Ann McNeill

It suggested that e-cigarettes may be contributing to falling smoking rates among adults and young people.

The review’s findings have sparked Public Health England into publishing a separate paper on the implications of the evidence, including the potential to prescribe e-cigarettes for smoking cessation.

In the policy paper, Public Health England said it looked forward to the “arrival on the market of a choice of medicinally regulated products that can be made available to smokers by the NHS on prescription”.

The evidence review, commissioned by Public Health England, was led by Professor Ann McNeill from King’s College London and Professor Peter Hajek from Queen Mary University of London.

The review found almost all of the 2.6 million adults using e-cigarettes in Great Britain were current or ex-smokers, most of whom were using the devices to help them quit smoking or to prevent them going back to cigarettes.

Public Health England

E-cigarettes are increasingly popular

Emerging evidence also suggested some of the highest successful quit rates were now seen among smokers who used a combination of an e-cigarette and additional support from their local stop smoking service, it concluded.

In addition, Public Health England said the review provided reassurance that “very few” adults and young people who had never previously smoked were becoming regular e-cigarette users – less than 1% in each group.

All the current evidence suggested that e-cigarettes carried a fraction of the risk of smoking, said the review.

However, despite this, the review raised concerns that increasing numbers of people think e-cigarettes were equally or more harmful than smoking.

Review author Professor McNeill said: “There is no evidence that e-cigarettes are undermining England’s falling smoking rates.

“Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely,” she said.

“Local stop smoking services should look to support e-cigarette users in their journey to quitting completely”

Kevin Fenton

She added: “E-cigarettes could be a game changer in public health, in particular by reducing the enormous health inequalities caused by smoking.”

Professor Kevin Fenton, director of health and wellbeing at Public Health England, said: “Smoking remains England’s number one killer and the best thing a smoker can do is to quit completely, now and forever.

“E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm,” he said. “Local stop smoking services should look to support e-cigarette users in their journey to quitting completely.”

However, he added: “The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting.”

Fresh Smoke Free North East was the first regional programme in England where all local NHS stop smoking services were actively promoted as “e-cigarette friendly”.

Lisa Surtees, acting director of Fresh Smoke Free North East, said: “Our region has always kept an open mind towards using electronic cigarettes, as we can see the massive potential health benefits from switching.

“All of our local NHS Stop Smoking Services now proactively welcome anyone who wants to use these devices as part of their quit attempt and increase their chance of success,” she said.

Professor Linda Bauld, a health policy and cancer prevention expert at the charity Cancer Research UK, said:  “Free stop smoking services remain the most effective way for people to quit, but we recognise the potential benefits for e-cigarettes in helping large numbers of people move away from tobacco.”

“Given the public uncertainty around e-cigarettes, Public Health England are to be applauded for taking the lead in outlining the evidence and basing their policy on it”

Penny Woods

Dr Penny Woods, chief executive of the British Lung Foundation, noted that the highest successful quit rates were being seen among smokers who are also using e-cigarettes.

“Providing healthcare professionals with accurate advice and information on their use is necessary if we are to unlock the full potential of e-cigarettes in helping people to kick their habit,” she said.

She added: “Concerns do remain as to the long-term health impact of e-cigarettes and… we must continue to monitor this area carefully.”

The support for e-cigarettes from Public Health England is in contrast to the Welsh government, which has previously published proposals to ban their use in enclosed spaces, following concerns they would re-normalise smoking.


Readers' comments (5)

  • delighted with this evidenced based information, i have come into contact with so many families were one or both parents have quited using e- cigarettes

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  • I've stopped smoking for 6 months thanks to my vaper after 45 years of trying NRT on and off and failing.
    The Welsh are mad to restrict their use - should be encouraging it instead, to reduce smoking

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  • Best thing since sliced bread. I've saved an absolute fortune since vaping

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  • If you can afford to smoke you can afford to vape. no way in our cash strapped nhs should we be spending money on subsidising smokers whats next paying for drinkers to buy lower alchol alternatives. I work onwards struggling to provide the basic euipment and a recent trust survey found over 46% of staff did not have adequate equipment to do the job. We have to ask the general public to assume the responsibility and cost for things like this.

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  • The e-cigarette harm has not been improved in long term yet. It will take time to see the side effects.
    I agree with the last Anonymous' comment.
    If someone is motivated or directed to give up smoking, fighting anxiety, nervosity, constipation and other signs indicating the lack of nicotine is hard, but with the will it is very possible and healthier than e-cigarette. I am afraid that e-cigarette and its promotion will actually cause more harm in a long term than promoting continuing visits with the doctors, who would follow the consumption of tobacco and motivate the person. However, it seems that it would cost more than providing an e-candy.

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