Quitting Cigarettes with e-cigs: what the NHS say
- 10 Jul, 2020
Last fact-checked 13 July 2020 | Report a factual error on this article
Here in the UK, smoking is still one of our biggest public health problems. With cigarettes accounting for 16% of all deaths and 4% of all hospital admissions in England footnote 1, any quitting tool that can help smokers quit safely deserves our full support.
But what do the NHS have to say about vaping as a quitting strategy? What’s the official UK position on e-cigarettes, and what evidence is there that e-cigarettes really are helping to turn the tide on tobacco?
In this article, we’ll walk you through the latest guidance from the NHS on vaping, and show you some interesting research from other government departments and British medical groups.
The NHS website states that vaping is “far less harmful than cigarettes and can help you quit for good.” footnote 2 This is a pretty strong endorsement for e-cigarettes, especially given the relatively short amount of time vaping technology has spent in the mainstream.
While the NHS recognises that e-cigarettes can be a helpful quitting tool, they have also made clear that vaping alone is not the most effective way to quit cigarettes. Based on the data that’s currently available, vaping will help you quit, but you’ll double your chances of success with support from a local NHS Stop Smoking Service.
Public Health England recently announced that people who use stop smoking aids (like vaping or nicotine patches) without any expert support are 1.5 times more likely to succeed, but quitters who combine stop smoking aids with “expert behavioural support” are 3 times more likely to quit than someone using willpower alone footnote 3. Expert behavioural support is, without a doubt, the best starting point if you’re trying to quit.
We need more research into the long-term effects of vaping, but based on the research that has been done so far, vaping is much safer and much healthier than smoking. Both the Royal College of Physicians and Public Health England have both estimated that vaping is at least 20 times safer than smoking. footnote 4
This has more to do with the dangers of smoking than it does the safety of vaping. According to the NHS, “smoking is the biggest cause of preventable deaths in England. Every 15 cigarettes you smoke will cause a mutation in your body … mutations are how cancers start.” footnote 5
While we will probably learn, in years to come, that prolonged e-cigarette use comes with its own set of risks, we already know for certain that smoking is incredibly dangerous. In a recent interview with the British Heart Foundation, Public Health England’s Martin Dockrell summed it up perfectly:
“We know that e-cigarettes are probably not completely safe, but that’s not the issue. The question is, are e-cigarettes safer than the alternative? It's really important that smokers understand how much safer e-cigarettes are, compared to smoking".
- Martin Dockrell, Tobacco Control Programme Lead at Public Health England
Unlike cigarette smoke, e-liquid vapour doesn’t contain any tar or carbon monoxide - two of the worst components of a cigarette, according to the NHS. footnote 6 By switching from tobacco to e-liquid, quitters still get the sensation they associate with smoking, but they stop these two lethal chemicals from entering their bodies.
What’s in a normal cigarette?
If you want to see the tar and other chemicals in cigarette smoke for yourself, take a look at this short video on the NHS website:
In the video, Dr Rosemary Leonard MBE & Dr Lion Shahab start out with two identical glass bell jars filled with cotton wool. They pump e-cigarette vapour through one jar, and cigarette smoke through the other, and they use the cotton wool to show us what our lungs are probably dealing with when we smoke or vape.
The jar with cigarette smoke is soon full of grime and tar - it’s shocking. You can see the video on the NHS website here: nhs.uk/smokefree/help-and-advice/e-cigarettes
The latest report from Public Health England shows that 1.2 million Brits have used e-cigarettes to successfully quit tobacco. Just take a look at the infographic below… footnote 7
1.2 million people quitting with the support of a vape device is great news — there’s no question — but it doesn’t tell the full story. Nearly one quarter of UK vapers — a whopping 600,000 people — currently smoke and vape at the same time. This number is far too high, and we hope that future studies will take a closer look at this.
Is vaping really helping us quit? Aren’t UK smoking rates already in decline?
Smoking prevalence (the percentage of the population who smoke) has been declining in the UK for decades, so can we really say that e-cigarettes are driving down smoking rates? This is an important question. Based on the UK smoking stats before and after 2012, we’re pretty confident that e-cigarettes are making a substantial contribution to our smoking rates.
According to the Office of National Statistics (ONS), In 1974, a whopping 45% of British people over the age of 16 were smokers. That percentage fell steadily by nearly 1% per year for the next 20 years, but by the mid-2000s, smoking rates had levelled out at about 20%.
In 2007, 21% of British people aged 16 or older were classed as smokers. That year, the UK Government banned smoking in enclosed spaces and changed the age limit on tobacco from 16 to 18. You might think that these new laws would have pushed our smoking rate down, but they had no real effect whatsoever. In fact, according to the ONS, “from 2007 to 2012 the rate of smoking remained largely unchanged”. footnote 8
In 2012, the popularity of e-cigarettes skyrocketed (see below), and Britain’s smoking prevalence rate (which had been stuck in the mud at 20% for half a decade) suddenly began to fall again.
The graph below shows the quitting routes used by smokers trying to quit, as recorded by UCL’s Smoking Toolkit Study, since 2007. E-cigarettes are the purple line: footnote 9
* Please note the dark blue line on this graph (NHS support, which is proven to be the most effective quitting route) is the least popular type of support used in smoker’s quit attempts. The light blue line at the top represents ‘no support’ (in other words, willpower), which is the least effective quitting route.
Even in 2020, most smokers are choosing the hardest way to quit tobacco.
If you’re trying to quit, get in touch with your local NHS Stop Smoking Service.
From 2012 to 2016, the prevalence of smoking in the UK, which had barely changed in the 5 years previous, was once again falling by almost 1% per annum (see the graph below). footnote 10 We can’t conclusively prove that e-cigarettes were the sole cause for this sudden change in Britain’s quitting rates (90% of us watched the London Olympics in 2012 footnote 11 - maybe we all got inspired and went on a health kick), but it’s highly likely that the rise in e-cigs and the fall in smoking rates are linked.
If you ask your doctor about e-cigarettes (or any other medical issue), they will rightly give you advice that is bespoke to you and your particular situation. We can give you an idea of what a health or social care worker might say to you, though.
The National Institute for Health and Care Excellence (NICE) have published a five-point summary of e-cigarette advice for care workers who work with smokers. The text below comes straight from the official guidance issued to British stop-smoking services and charities — you can read the full document here.
NICE’s Official Advice on e-Cigarettes
These recommendations are for health and social care workers in primary and community settings. For people who smoke and who are using, or are interested in using, a nicotine-containing e‑cigarette on general sale to quit smoking, explain that:
Read the full guidance at https://www.nice.org.uk/guidance/ng92
At Gourmet eLiquid, we’re ex-smokers ourselves, so we know what you’re going to go through when you try to quit. However you choose to quit, our advice is to take all the help you can get, and remember the research: ‘willpower alone’ is literally the least effective way to quit cigarettes!
Vaping will help you quit, but vaping works best when you’re also getting support from a stop smoking service. Your local NHS Stop Smoking Service is a free service and it works. The latest results (April 2019 to December 2019) show that 51% of people who used NHS Stop Smoking services had quit within 4 weeks. footnote 12 That’s an incredible success rate.
We hope this article has shone some light on the official UK position on e-cigarettes. If you have any other questions you would like us to answer, either about vaping in general or any of the products we sell, please get in touch.
We wish you the best of luck on your quitting journey. Let us know how you get on!
- John Boughey
Links & Citations
These 16% and 4% figures come from “Statistics on Smoking, England - 2019”, which is the most recent statistical report from the NHS. The NHS have not published the 2020 report yet, and we may find that these figures are worsened by the Coronavirus outbreak. We’ll update these stats as-and-when we know more. The full 2019 report can be found below:
See the full quote, and more advice on using e-cigarettes to stop smoking, at the link below:
This infographic comes from the Gov.uk website and can be found at the link below. The same web page states that “currently, around half of all smokers in England try to quit unaided using willpower alone, despite this being the least effective method.”
“Leading health organisations including the Royal College of General Practitioners, British Medical Association and Cancer Research UK agree that e-cigarettes are far less harmful than smoking. Based on the currently available evidence, Public Health England and the Royal College of Physicians estimate they are at least 95% less harmful.” - see “How Safe Are Cigarettes?” on the NHS website at https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes
“Smoking is the biggest cause of preventable deaths in England, accounting for nearly 80,000 deaths each year. One in two smokers will die from a smoking-related disease. … Every 15 cigarettes you smoke will cause a mutation in your body, mutations are how cancers start.”
The NHS Advice page on e-cigarettes states that “E-cigarettes don't contain tobacco and don't produce tar or carbon monoxide, two of the most damaging constituents in cigarette smoke. ” You can read the full quote on the What are e-cigarettes and how do they work? section of the page below:
The infographic can be downloaded from the Gov.uk website at the link below:
The full ONS report, titled “Opinions and Lifestyle Survey, Smoking Habits Amongst Adults, 2012”, can be found on the National Archives website at the link below:
The popularity of e-cigarettes over time can be found on the “Monthly tracking of key performance indicators” Powerpoint file, available for download on the Smoking in England website at http://www.smokinginengland.info/latest-statistics/
The graph showing the percentage of current smokers and cigarette smokers who have quit (20% and 50% respectively in 2012) can be seen on the ONS website at the link below:
The 90% Olympic viewership statistic is one of many interesting stats on the legacy of the London 2012 games, visible on the Olympic Games fact sheet at the link below:
The 51% quitting success rate was verified with carbon monoxide testing. You can read all about the NHS Stop Smoking success rates at the link below: