1. Tobacco harm reduction in the UK: e-cigarettes
(EC) are making a difference
Louise Ross
• Freelance consultant at the National Centre for Smoking
Cessation and Training
• Former Stop Smoking Service Manager
Leicester City Council
• Vice-Chair, New Nicotine Alliance UK
October 2019

2. Since No Smoking Day 2014,
the Leicester City Stop Smoking
Service has welcomed people
who want to use EC/vaporisers
to stop smoking.
Many of these use NRT too
The team have tackled the fact
that they are not experts in
vaping. They have worked hard
to extend their knowledge.
, and

3. Results?
Results?
With EC, success rates
were up to 20% higher than
with NRT alone.
Many found a combination
of EC and NRT (and even
Champix) suited them well
The service now supplies
free EC starter kits and
other services around the
country having started to do
the same.

4. Consistent success, year on year
 2014-15 total
 2,005 quits from
4,098
 2015-16 total
 1,920 quits from
3,718
 2016-17 total
 1,631 quits from
3,184
 2017-18 total
 1,479 quits from
2,753
 2018-19 total
 1331 quits from 2414
 180 EC quits from 293: 61% success
 487 EC quits from 752: 65% success
 512 EC quits from 851: 60% success
 573 EC quits from 917: 62% success
 556 EC quits from 844: 66% success

5. Who says it’s safer or more effective?
 Public Health England
 Royal College of Physicians
 Action on Smoking and Health
 House of Commons Select Committee
 National Centre for Smoking Cessation and Training
 Cancer Research UK
 Challenge Group on Smoking in Pregnancy
‘Vaping poses only a small fraction of the risks of
smoking and switching completely from smoking to
vaping conveys substantial health benefits’
Public Health England 2018

6. The big myths:
Health harms
Fear of nicotine
Smokers don’t know what’s
best for them
Gateway concerns
Lack of evidence

7. Myth 1 - we don’t
know about
possible health
harms
• The people who we want to switch
to vaping are already smoking
• There are no products of
combustion in EC vapour
• It’s the tar and carbon monoxide in
a smoked cigarette that cause the
damage
• The Popcorn Lung stories are
made-up nonsense (but how they
persist!)

8. Myth 2 –
nicotine is
highly
addictive and
toxic
• Experience shows that
once nicotine is used
through vaping, levels
needed to maintain
comfort can be reduced
• It’s the same nicotine that
is used in patches and
gum – it doesn’t get
sanctified just because it’s
medicinal
• Many health workers, and
the general public, still
think nicotine is the most
harmful chemical in a
cigarette
This Photo by Unknown Author is licensed under CC BY-SA

9. Myth 3 - smokers
don’t know what’s
best for them
• Listen to people when they say
vaping made a difference after
they had tried everything else
• Don’t tell them they have to either
quit or, basically, die
• Recreational nicotine is
pleasurable as well as a relief from
urges to smoke
• Flavours are important to adults
• Don’t tell them they’ve got to stop
using their vaporiser as soon as
possible
This Photo by Unknown Author is licensed under CC BY-ND

10. Myth 4 - it’s a
gateway to
smoking
There is NO evidence of this, and
it’s being observed very closely
by ASH, PHE, CRUK. With strict
regulation, young people who
have never smoked are NOT
starting to vape in anything more
than negligible numbers
The gate would appear to swing
the other way - out of smoking
This Photo by Unknown Author is licensed under CC BY-SA

11. Myth 5 – There’s
no evidence
• It’s frequently claimed that
‘we don’t know enough
about them’
• There’s more research
about EC than probably
any other health
intervention, but some of
it is poor quality and
misleading
• In the fast-moving world of
harm-reduced products,
listen to the consumers
who say ‘This changed my
life’

12. When you see someone vaping,
celebrate the fact that they’re NOT
smoking
Without the smoke, getting
nicotine from vaping is a good
harm reduction strategy.
Smoke kills, clean nicotine
does not

13. EC: take-home messages
 They’re not cigarettes
and shouldn’t be
treated as such in law
 You don’t smoke them
 Patients who have
switched completely to
vaping are ex-smokers
 Don’t push them to
come off vaping