Experts have called for a crackdown on the sale of vapes to children as a new review concluded little is known about the long-term impact of e-cigarettes on health.
The King’s College London study, commissioned by the Office for Health Improvement and Disparities at the Department of Health, said it was clear that vaping is less harmful than cigarettes in the short to medium term and smokers should be encouraged to switch to vapes.
However, it called for more research on the risks of vaping for those people who have never smoked or vaped before.
And current research is not robust enough to make clear conclusions about how harmful vaping is in the longer term, according to the study.
Research published in July found the proportion of children vaping is on the rise, with many being influenced by social media sites such as TikTok.
Newer, disposable e-cigarettes are increasing in popularity, in part because they cost around £5 each and come in a wide range of fruity flavours.
A survey of children, carried out for Action on Smoking and Health (ASH), found that, over the last year, a new generation of disposable vapes known as ‘puff bars’ – which contain nicotine – have come on to the market.
While it is illegal to sell vapes to under-18s, social media carries posts from teenagers showing the new vapes and discussing flavours such as pink lemonade, strawberry banana and mango.
The poll found the proportion of children aged 11 to 17 currently vaping has jumped from 4% in 2020 to 7% in 2022.
In 2013, just 3% of children aged 11 to 15 had ever vaped, but this rose to 8% in 2020 and 10% in 2022.
We strongly discourage anyone who has never smoked from taking up vaping or smoking
Professor Ann McNeill, King's College
The new King’s College study concluded that smokers who switch to vapes will have a substantial reduction in their exposure to toxins that promote cancer, lung disease and cardiovascular disease.
But it said people who have never smoked should not take up vaping as it was not free from risks.
Lead author Professor Ann McNeill, a professor of tobacco addiction at King’s College London, said: “Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet around two-thirds of adult smokers who would really benefit from switching to vaping don’t know that vaping is less harmful.
“However, the evidence we reviewed indicates that vaping is very unlikely to be risk-free.
“So we strongly discourage anyone who has never smoked from taking up vaping or smoking.”
Helping people switch from smoking to vaping should be considered a priority if the Government is to achieve a smoke-free 2030 in England
Dr Debbie Robson, King's College
When it comes to selling vapes to under-18s, the study said local authority trading standards efforts “have been scaled down and compliance with regulations is not enough to prevent underage sales and access to illicit products.”
It added that “more frequent surveillance of single-use disposable vaping products”, which are popular with children, is now needed.
The report looked specifically at the risks of vaping versus not vaping at all and found that exposure to carcinogens (substances that can cause cancer) was similar, or in some cases higher, for vaping.
This was true for exposure to NNK (NNAL), which have been found to be “powerful pulmonary carcinogens in animals and humans”, the study said.
Where NNK (NNAL) levels were higher than in non-users, levels were generally substantially lower (around 95% lower) among vapers than smokers.
When it came to toxicants affecting the respiratory system, the risks were similar for vapers and non vapers.
Dr Debbie Robson, senior lecturer in tobacco harm reduction at King’s and one of the report’s authors, said the evidence was clear that vaping was less harmful than smoking.
With Stoptober just starting, it’s important that smokers are aware that the evidence is clear that vaping poses a small fraction of the risk of smoking
Deborah Arnott, ASH
She added: “Helping people switch from smoking to vaping should be considered a priority if the Government is to achieve a smoke-free 2030 in England.”
Dr Jeanelle DeGruchy, deputy chief medical officer for England, said: “Every minute someone is admitted to hospital in England due to smoking.
“Every eight minutes someone dies a smoking-related death.
“Vaping is substantially less harmful than smoking so the message is clear, if the choice is between smoking and vaping, choose vaping.
“If the choice is between vaping and fresh air, choose fresh air.”
Deborah Arnott, chief executive of ASH, said: “The Government has now published five independent reports which together provide the best available evidence to underpin the UK’s policies on vaping.
“With Stoptober just starting, it’s important that smokers are aware that the evidence is clear that vaping poses a small fraction of the risk of smoking.”
There are currently around six million smokers in England and about 3.8m vapers.
The King’s researchers said a previous Public Health England claim that vaping is at least 95% less harmful than smoking is “broadly right” over the short to medium term, but longer term studies are needed.
Lion Shahab, a professor of health psychology and co-director of the Tobacco and Alcohol Research Group, at University College London, said of the work: “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.