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PHE: “False fears” are making smokers shun e-cigarettes

March 4, 2020


The detrimental effect of misinformation about e-cigarettes and their dangers has been highlighted in a report commissioned by researchers at King’s College London.

The report showed that vape use has remained stable since the US stories about EVALI lung disease surfaced but the number of smokers who believed vaping was more harmful than tobacco smoking was concerning. A statement released by public Health England said:

“The mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among UK smokers following the US lung injury outbreak in autumn 2019. US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping products, was a primary cause of the US outbreak. This substance is banned from UK regulated nicotine vaping products.”

Public Health England’s advice continues to be that current smokers should transition to e-cigarettes as a less harmful option, while underlining the fact that e-cigarettes are not a risk-free option.

The statement said: “E-cigarettes are much less harmful than tobacco but are not completely safe. They contain significantly less harmful chemicals which cause diseases related to smoking but the long-term impact of using e-cigarettes will remain unknown for some time.”

In addition, the report includes a number of recommendations:

  • Proof of age at sale of vaping products needs to be better enforced to protect young people;
  • Health professionals should use advice on using e-cigarettes during pregnancy;
  • More research is needed into vaping among smokers with mental health conditions and pregnant smokers; and
  • More research is needed into e-cigarette flavour preferences among young people.


The comments come a week after Vape Business reported on the admission by US authorities that nicotine vaping had not been responsible for the cases of so-called EVALI. In an update the CDC said:

“Due to continued declines in new EVALI cases since September 2019, and the identification of vitamin E acetate as a primary cause of EVALI, today’s release is the final biweekly CDC update on the number of hospitalized EVALI cases and deaths nationally.”

The PHE will be hoping its statement and this review help shake the industry and other stakeholders into action as we all work to cut smoking rates and save lives.


Professor John Newton, Director of Health Improvement at Public Health England, commented on the review:

“It is concerning to see how much the US lung disease outbreak has affected smokers’ views on e-cigarettes here in the UK. Safety fears may well be deterring many smokers from switching, leaving them on a path to years of ill health and an early death due to their smoking. The US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping liquid, was a primary cause of the US outbreak. This substance is banned in UK-regulated nicotine vaping products.

“E-cigarettes are far less harmful than smoking, which causes 220 premature deaths a day in England. Our advice remains that for anyone who smokes tobacco, the most important thing is to stop smoking altogether and e-cigarettes can be an effective way to help smokers do that.

“Our new advice on vaping in mental health trusts is an important step forward in empowering healthcare professionals to talk more confidently with their patients about the benefits of using e-cigarettes to stop smoking. This advice is another step towards the overall goal of a smokefree generation.”

Chief Medical Officer for England Professor Chris Whitty said:

“The best thing a smoker can do for their health is stop smoking completely. Electronic cigarettes can help some people quit smoking and are a safer alternative.

“This report is a further welcome contribution to building the evidence around an important area of public policy and highlights the challenge of maximising the opportunities e-cigarettes present while managing the risks associated with nicotine.”

Professor Ann McNeill, Professor of Tobacco Addiction at King’s College London, and lead author of the report said:

“It is currently very hard for smokers to make sense of the many contradictory reports on the impacts of vaping and smoking. In our review we present evidence that suggests in England, vaping has not undermined declines in adult smoking, and for youth, vaping is mainly concentrated in those who were already dabbling in cigarette smoking. However, we need to remain vigilant and ensure that vaping products, alongside regular cigarettes, are not easily accessible to young people.”

Responding to the report, Fredrik Svensson, BAT’s General Manager for UK and Ireland, said:

“It is deeply worrying that over half of smokers think that vaping is as harmful – or more harmful – than smoking. The scientific evidence shows that this is not the case, and public bodies such as PHE, Cancer Research UK and the Royal College of Physicians have endorsed vaping as a less harmful alternative to tobacco.”