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Evidence Review of E-cigarettes and Heated Tobacco Products 2018 by Public Health England Released

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Earlier today Public Health England released the “Evidence review of e-cigarettes and heated tobacco products 2018“. The report marks the fourth report in PHE’s series on e-cigarettes, including their much covered findings from 2015 where they stated that e-cigarettes are around 95% less harmful than tobacco.

Some of the key findings of PHE’s Evidence Review include:

  • Vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits;
  • E-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more;
  • E-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country;
  • Many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40% of smokers have not even tried an e-cigarette;
  • There is much public misunderstanding about nicotine. Less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine;
  • The use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million;
  • The evidence does not support the concern that e-cigarettes are a route into smoking among young people. Youth smoking rates in the UK continue to decline. Regular use is rare and is almost entirely confined to those who have smoked.
  • Never smokers in the UK who try e-cigarettes are more likely to have tried smoking subsequently than those who have not tried e-cigarettes. A causal link has not been established and neither has progression to regular smoking. The ‘common liability’ hypothesis seems a plausible explanation for the relationship between e-cigarettes and smoking implementation.
  • One assessment of the published data on emissions from cigarettes and e-cigarettes calculated the lifetime cancer risks. It concluded that the cancer potencies of e-cigarettes were largely under 0.5% of the risk of smoking.
  • To date, there have been no identified health risks of passive vaping to bystanders.
  • Reporting of some academic studies has been misleading.

PHE’s evidence review comes just a few weeks after a US National Academies of Sciences, Engineering and Medicine report on e-cigarettes. Their conclusion on e-cigarette safety also finds that based on the available evidence “e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.”

Prof. John Newton, Director for Health Improvement at PHE said:

“Every minute someone is admitted to hospital from smoking, with around 79,000 deaths a year in England alone.”

“Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know.”

“It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.”


Currently located in Sydney, Australia, I have been vaping since 2009 and became active in the e-cigarette industry in late 2015. Since then I’ve had the pleasure of visiting over 700 shops in 6 countries.

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