Up in smoke

This report from the UK think tank the Adam Smith Institute looks at efforts to unlock tobacco harm reduction.

A new paper by Daniel Pryor, a Research Economist and Head of Programmes at the Adam Smith Institute, argues that the United Kingdom defends vaping and argues that the UK should redouble efforts to unlock further tobacco harm reduction: The United Kingdom is a world leader in encouraging smokers to switch to alternative, less harmful nicotine products. Britain’s success is closely linked to the broad, evidence-based consensus in favour of e-cigarettes as a smoking cessation tool. Public Health England has declared that vaping is “at least 95% less harmful”. There is a very strong correlation between the reduction in cigarette usage and the increase in e-cigarette usage in recent years. According to PHE estimates, up to 57,000 more people have quit a year due to e-cigarettes. The available evidence does not substantiate recent concerns about e-cigarettes. The vast majority of e-cigarette users are former (53%) or current ‘dual users’ (39%) of cigarettes. Relatively few young people in the UK have taken up vaping and less than 1% of young people who have never smoked have tried vaping products. Furthermore, safety risks related to illicit products have not and are unlikely to become a concern in the UK.

There is a need for further progress in harm reduction: there are 8.56 million smokers in Great Britain, 4.37 million smokers have tried e-cigarettes but gone back to smoking, while 2.88 million smokers have yet to try a reduced-risk product. There is widespread misinformation about the relative risk of e-cigarettes. Over two-fifths (43%) of UK smokers do not believe that e-cigarettes are less harmful than tobacco cigarettes. The most common reason for e-cigarette users returning to smoking is that vaping “didn’t feel like smoking a cigarette.” Leaving the European Union presents an opportunity for the UK to liberalise the treatment of reduced risk products, including harnessing the potential of alternative reduced-risk products such as heated tobacco and oral nicotine pouches, and ensuring high levels of public awareness about the relative risk levels of different products. If the Government wants to turbocharge tobacco harm reduction and achieve its stated goal of a ‘smoke-free’ society by 2030, they should: (1) Develop an evidence-based set of generic health claims that can be used by regulated e-cigarette marketers to advertise products; (2) Commission independent research to develop the evidence base in relation to heated tobacco products, with a view to allowing accurate communication of this information by marketers; (3) Reform counterproductive elements of the EU Tobacco Products Directive post-Brexit; (4) Implement risk-based taxation to incentivise switching to reduced-risk products, building on the creation of a separate taxation category for heated tobacco; (5) Legalise snus post-Brexit with a sensible regulatory framework; (6) Encourage the NHS to take a leadership role in promoting tobacco harm reduction across trusts; (7) Allow cigarette pack inserts that exclusively advertise reduced-risk products.

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