This is part of a series of “THR 101 Reviews,” which examine studies and data on electronic cigarettes and vaping devices.

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Public Health England (PHE) is an executive agency within the Department of Health and Social Care in the United Kingdom. The agency “exist[s] to protect and improve the nation’s health and wellbeing, and reduce health inequalities.” In this sense, PHE operates similarly to the US Food and Drug Administration.

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Since 2015, PHE has been a leading agency providing information on electronic cigarettes and vaping devices. In it’s landmark 2015 report, E-cigarettes: an evidence update, PHE concluded “that e-cigarettes are around 95% safer than smoked tobacco and they can help smokers to quit.” Since then, PHE has given annual updates of the 2015 report.

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Recently, the agency published a March 2020 evidence update. The March update is PHE’s “sixth report in a series of independent reports” and analyzes e-cigarette use among youth and adults, as well as addressing vaping-related lung illnesses.

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According to PHE, “current vaping” among youth in England “has remained reasonably steady with the best recent estimates putting it at 6% of 11 to 15-year-olds in 2018 and 5% of 11 to 18-year-olds in 2019.” Overwhelming most youth in England have used combustible cigarettes prior to using vapor devices with less than once percent “of young people who have never smoked are current vapers.” Similar to the United States, youth in England use vaping products due to “curiosity,” and nearly 60 percent of 11 to 15-year-olds that vaped regularly – more than once a week – “reported by given vaping products, mostly by friends.”

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Among English adults, vapor product use “has remained stable since 2014,” with 5 to 7 percent of the adults in England using vaping devices. Further, vaping prevalence among former smokers continues to increase, with 12 to 13 percent of former smokers now being current vapers. Similar to English youth, less than 1 percent of adults “who have never smoked [are] currently vaping.”

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PHE addresses vaping-related lung injuries, noting that in the United States “where there is a very different regulatory system for vaping products […] there was a spate of serious lung diseases and deaths which appeared to peak in late 2019.” PHE remarks that most of these “seem” to be caused by vaping devices containing “tetrahydrocannabinol (THC) oil and vitamin E acetate.” Interestingly, there “has been no similar lung disease outbreak in England.”

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Deeply problematic in PHE’s report is the increased misinformation surrounding the reduced harm of e-cigarettes and vapor products, with PHE remarking that “[p]erceptions of harm from vaping among smokers are increasingly out of line with the evidence” and that the “proportion who though vaping was less harmful than cigarettes declined from 45% in 2014 to 34% in 2019.”

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PHE’s latest report offers insight to policymakers seeking to regulate e-cigarettes and vapor products. These are tobacco harm reduction tools that have helped millions of American adults quit smoking.

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This report also adds on to PHE’s other analyses of vapor products. In 2018, the agency published an evidence review of e-cigarettes and heated tobacco products which examined the role of nicotine, e-cigarette use and effectiveness as a cessation tool, and the health risks of e-cigarettes.  

In its 2018 update, PHE noted that nicotine itself does not cause the most harm from combustible cigarettes, although adults erroneously believe it does. Further, PHE noted that e-cigarettes have helped reduce the number of smokers in England by tens of thousands. Moreover, PHE reiterated its findings that e-cigarette use is at least “95% safer” than smoking combustible cigarettes.

 

The latest 2020 report from PHE adds to growing body of evidence that e-cigarettes are significantly less harmful than combustible cigarettes and are an effective tool in helping smokers quit. Policymakers should adhere to these findings when seeking to regulate electronic cigarettes and vaping devices and promote the role of tobacco harm reduction.

 

 

Nothing in this analysis is intended to is intended to influence the passage of legislation, and it does not necessarily represent the views of Tobacco Harm Reduction 101. For more information on tobacco and vapor products, please visit https://www.thr101.org.