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expert reaction to Nicotine vaping in England: an evidence update, as published by the Office for Health Improvement and Disparities (OHID) and authored by scientists at KCL

An evidence update on nicotine vaping in England by scientists at King’s College London has been published by the Office for Health Improvement and Disparities (OHID).


This Roundup accompanied an SMC Briefing.


Prof Caitlin Notley, Professor of Addiction Sciences, Norwich Medical School, University of East Anglia, said:

“The latest evidence review confirms that vaping is substantially less harmful than continuing to smoke tobacco. Reassuringly, the evidence shows that people who switch away from smoking to vaping are exposed to fewer toxic chemicals that may cause disease in later life.

“There is still a need for research exploring any long-term health outcomes of vaping amongst people who have never smoked tobacco. There is also a need for research to understand any potential health harms of vaping during pregnancy. However, it is clear that all people who smoke, including pregnant women, should switch to vaping to help them move away from tobacco, which is without doubt, extremely harmful to health.”


Dr Lion Shahab, Professor of Health Psychology and Co-Director of the Tobacco and Alcohol Research Group, University College London, said:+

“This latest report on nicotine vaping is by far the most rigorous, comprehensive and up-to-date piece work on this topic ever published in the UK. It confirms findings from previous reviews in this area that nicotine vaping is far less harmful than smoking tobacco, based on a summary assessment of numerous studies on the likely health impact of vaping. By implication, this should give reassurance to health services and policy makers that encouraging smokers who are unable to stop smoking to switch to these reduced harm products will benefit population health.

“At the same time, the report acknowledges that vaping carries some risks compared with not using any product at all, but that these concerns are often overstated, resulting in false risk perceptions that may dissuade those using the riskiest product (cigarettes) from switching to lower risk products (e-cigarettes). Given recent increases in youth vaping, this means that the right balance needs to be struck in terms of maximising the benefits of vaping while reducing unintended negative consequences.

“As such, we should ensure that adult smokers get the right support, which includes provision of accurate information about the reduced risk of vaping and how it can help them stop smoking, while also offering educational material to young people who would have never smoked to discourage them from starting to vape, in addition to better reinforcement of age of sale and advertising restrictions. If this balance can be struck, e-cigarettes can play a powerful role in consigning smoking cigarettes to the history books in the UK.”


Dr Jamie Hartmann-Boyce, Associate Professor at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said:

“This is a comprehensive, well-conducted review covering a large and ever-growing body of evidence showing that, though not risk free, vaping exposes users to considerably lower levels of harmful substances than cigarettes. Smoking remains a leading cause of health inequalities in England and the largest single risk factor for death globally. Most people who smoke want to quit, but find it difficult to do so. The findings in this new review support the use of e-cigarettes as a way to help people quit smoking, which is encouraged by the British government and healthcare services.

“People who have switched from smoking to vaping should feel reassured that in doing so, they are likely to have improved their health. People who still smoke should switch completely to vaping, and can be supported in doing so through NHS stop smoking services. The report also highlights that though FAR less harmful than smoking, vaping still carries some risks, and people who don’t smoke should not start vaping.

“The studies investigating e-cigarettes as a stop smoking tool tend to find mild side effects that often decline over time, but because of differences in device characteristics and relatively little long-term data it remains challenging to nail down the specific harms from e-cigarettes overall.”


Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:

This is a large review of what is currently known about e-cigarettes and especially about their safety. With much more information available now, the review confirms the previous estimates that vaping carries only a small fraction of the health risks of smoking. 

“The clearest evidence comes from looking at blood and saliva samples of vapers and smokers. In vapers, the chemicals responsible for smoking-related death and disease are either completely absent, or present at much lower levels, often similar to levels found in non-smokers. 

“Smokers should be emphatically advised that switching to vaping removes almost all of the risks of smoking.”


Dr Sarah Jackson, Principal Research Fellow, Tobacco and Alcohol Research Group, University College London, said:

“This rigorous report provides a comprehensive update on the health risks associated with using e-cigarettes and should provide reassurance to smokers, policy makers, and clinicians. Many smokers are unsure whether e-cigarettes are a safer alternative to smoking but, as this report shows, the evidence is clear. If you’re a smoker, you can substantially reduce the risks to your health by switching completely to e-cigarettes and continuing to use them for as long as you need to avoid relapse to smoking. If you don’t smoke, it is safer for you not to start vaping.”


Professor Jacob George, Chair of Cardiovascular Medicine and Therapeutics at University of Dundee Medical School, said:

“I welcome this comprehensive review that clarifies the current evidence base  and helps to debunk the many myths surrounding vaping. In essence what it says is that vaping is not completely safe but current evidence suggests that it is less harmful than tobacco smoking.  

“Tobacco smoking damages blood vessels causing narrowing and stiffness which results in high blood pressure, heart disease and stroke; vapes may contain some potentially harmful substances such as flavourings but in comparative terms, vapes have far fewer harmful toxicants compared to tobacco. Further research is urgently needed to assess the longer term impact of vaping on health.”                      



Nicotine vaping in England: an evidence update including health risks and perceptions’ by Ann McNeill et al. was published by the Office for Health Improvement and Disparities (OHID) at 5pm UK time on Thursday 29 September 2022.



Declared interests

Dr Hartmann-Boyce receives research funding from Cancer Research UK, the University of Oxford, and the National Institute for Health and Care Excellence on topics related to this report. She has received funding from the British Heart Foundation and the World Health Organization on unrelated topics. She writes on the topic of e-cigarettes and leads two Cochrane reviews of e-cigarettes, which are referenced in the report.

Prof Shahab contributed evidence to this report

Dr Jackson: “none to report.”

Prof Hajek: “contributed evidence to this report.”

Prof George: “I contributed evidence to the cardiovascular section of the review.”

Prof Notley: “No COIs to report.”

For all other experts, no reply to our request for DOIs was received.

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