18 April 2024

E-cigarettes and harm reduction: An evidence review

E Cigarettes And Harm Reduction Report Cover

The new RCP report, E-cigarettes and harm reduction: An evidence review, looks at several themes, including how e-cigarettes can be used to support more people to make quit attempts while discouraging young people and never-smokers from taking up e-cigarette use. It also examines trends in tobacco and vaping use, the effectiveness of e-cigarettes to treat tobacco addiction, and the differences in health effects of vaping in people who smoke, vape or do neither, the role of the tobacco industry in the rising use of e-cigarettes, and the ethical dilemmas presented by e-cigarettes.   

With over 50 recommendations, the report concludes that e-cigarettes remain an important tool to alleviate the burden of tobacco use but that much more can and should be done to reduce their appeal, availability and affordability to people who do not smoke, including children and young people, and reduce environmental harms. 

It makes several recommendations for regulations on vaping to protect young people and never smokers from vaping: 

  1. Price – raising their price by introducing an excise tax and minimum unit pricing while banning multi-buy purchases but making sure they remain a less expensive option for adults using them to quit smoking. 
  2. Promotion – restricting ‘point of sale’ in store promotional materials and product visibility, and restricting promotion on social media. 
  3. Purchase – ensuring Trading Standards services are sufficiently resourced to effectively enforce e-cigarette sales legislation and reduce underage sales. 
  4. Products – making products less appealing to young people by introducing standardised packaging and flavour descriptors. Require manufacturers to limit the production of toxic substances from vapes, require the Medicines and Healthcare products Regulatory Agency (MHRA) to independently verify product contents, provide advice to consumers on which are the safest products if using them to stop smoking and require manufacturers cover the costs of recycling. 

The new report follows several previous RCP publications on e-cigarettes and vaping, including: 

  • Harm reduction in nicotine addiction – a report on alternative nicotine products published in 2007, which covered their regulation and role as alternatives to smoking. The report concluded that there was a role for alternative nicotine products to support people to stop smoking tobacco and that regulation for those products should be formalised.  
  • Nicotine without smoke, which re-examined emerging data on the role of e-cigarettes and alternative nicotine products. The 2016 report concluded that e-cigarettes were an effective aid to quitting smoking but there needed to be regular surveillance to monitor intended and unintended consequences of regulation.  

For further information or if you have any questions, please email policy@rcp.ac.uk.