E-cigarettes – insights from England
Professor Ann McNeill
1Institute of Psychiatry, Psychology and Neuroscience, King’s College London.
Abstract:
The Government’s Tobacco Control Plan committed Public Health England to update the evidence base regularly on e-cigarettes, and as lead author of these evidence reviews since 2015, this presentation will summarise evidence on e-cigarette use in relation to cigarette smoking and the regulatory frameworks for both e-cigarettes and tobacco cigarettes. The evidence reviews draw on a variety of different data sources including government and non-governmental nationally representative surveys.
Aside from prohibition, England has one of the more robust regulatory frameworks for e-cigarettes worldwide which balances effective and regulated products which are attractive and accessible to adult smokers whilst not being appealing to never smokers. Importantly, the framework encourages access to e-cigarettes and other less harmful nicotine products among disadvantaged, as much as advantaged, smokers. The English government recently stated its intention to go completely smoke-free by 2030.
Smoking prevalence has continued to decrease in England with an all-time low of 14% recorded among adults in 2019, but has plateaued over recent years among schoolchildren at around 5%. E-cigarette use increased rapidly when e-cigarettes entered the market but their use has plateaued in recent years at around 6% among adults. There has been no rapid rises of e-cigarettes among youth as witnessed elsewhere with around 5% saying they use currently (at least occasionally). Use is concentrated in people who have experience of smoking, for example less than 1% of young people who have never smoked are current vapers. Data from randomised controlled trials, stop smoking services and observational studies in England indicate that e-cigarettes are helping smokers to stop. However, around a third of adult smokers say they have never tried an e-cigarette and harm perceptions are increasingly out of line with the evidence.
E-cigarettes are seen as one of a large battery of measures to support England’s smokefree target but regular monitoring continues to be essential to ensure potential benefits are maximized whilst managing potential risks.
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Conflicts of interest: I have not taken funding from the tobacco, e-cigarette or pharmaceutical industries. I have a tenured academic position and my research income is from governmental and non-governmental bodies.
Email: ann.mcneill@kcl.ac.uk