Just some years in the past, vaping was extensively accepted within the UK as a key software for tackling tobacco habit – an answer that, whereas not excellent, was vastly higher than smoking.
Then, youth vaping shifted the narrative.
Now the message, at the very least amongst policymakers, has modified from vaping being 95% much less dangerous than smoking, to a behavior that may be just a little higher than smoking – and one which is seducing a technology of younger folks right into a lifetime of nicotine habit.
The result’s a deluge of laws that might redefine vaping as we all know it. Show bans threaten the survival of impartial vape outlets, flavour restrictions may strip vaping of its attraction in comparison with smoking, and elevated taxes may have a big impact on the price of vaping.
As these challenges loom, the E-Cigarette Summit presents a vital alternative to collect main specialists from the UK and around the globe. Their skilled data and opinions have the potential to form each the controversy and laws that lies forward. Whether or not you are a policymaker, advocate, or just fascinated with the way forward for vaping, this abstract of the Summit’s key takeaways will assist you perceive the challenges forward – and the proposed options.
Session 1: Context, Proof & Authorities Challenges
Opening Keynote: Conceptualising THR and balancing medical and inhabitants concerns
Prof Peter Selby
Giblon Professor and Vice Chair of Analysis, Division of Household and Group Drugs, College of Toronto.
Habit doctor Dr Selby shared insights into hurt discount methods. Central to his speak was Challenge Vector – an initiative synthesising analysis on vaping and e-cigarette use to create actionable suggestions. Dr. Selby emphasised the significance of distinguishing absolute danger (e.g., younger folks beginning to vape) from relative danger (e.g., people who smoke switching to vaping). Whereas vaping is just not with out danger, for folks unable to give up smoking it’s a considerably much less dangerous various:
“If a teenager begins vaping with out ever smoking their absolute danger leaps—however the story is solely completely different for a smoker unable to give up combustibles.”
Dr. Selby advocated for nuanced frameworks that prioritise each particular person wants and broader public well being targets. Hurt discount is ever-evolving however stays a vital software in lowering smoking-related hurt:
“A pursuit of zero danger is unrealistic, however with knowledgeable intervention, we are able to stop immense hurt and save lives.”
The Tobacco & Vapes Invoice
Richard Boden
Deputy Director Tobacco and Vaping Coverage and Laws, Workplace for Well being Enchancment and Disparities, Division of Well being and Social Care
James Dunworth
I received’t cowl this in-depth, as Boden’s speak was basically a recap of what’s within the Tobacco and Vapes Invoice (summarised right here).
One factor that I had missed earlier than was the responsibility to seek the advice of earlier than implementing key modifications similar to flavour restrictions. This wasn’t within the unique Tobacco and Vapes Invoice, however is essential as session might assist stop probably the most dangerous measures from being taken – such banning all flavours bar tobacco or menthol.
Situating e-cigarettes for hurt discount within the wider context
Prof Jamie Brown
Professor of Behavioural Science and Well being, College School London (UCL)
James Dunworth
Each day cigarette smoking in England has plummeted by greater than half since 2007, reaching a low of 10.5% in 2024. Nevertheless, this constructive information has masked an increase in non-daily smoking – which is now 25% of all smoking habits.
“This shift is a double-edged sword. Whereas every day smoking declines, the rise in non-daily smoking means general progress is much less steep.”
Discrepancies between the STS and the Annual Inhabitants Survey (APS) – England’s official software for monitoring smoking prevalence – additional complicate the narrative. Modifications to APS’s smoking-related questions in 2016 possible excluded non-daily people who smoke from its information, presenting a very optimistic view of the smoking panorama. For instance, whereas the APS estimated smoking prevalence at 11.6% in 2023, the STS positioned the determine at 16.5% when non-daily and non-cigarette tobacco use have been included.
“We’re dealing with a extra sophisticated actuality than the APS portrays. 1 / 4 of people who smoke now smoke non-daily, and this group is disproportionately made up of every day vapers.”
The function of vaping and the perceptions of vaping in these traits is vital. In 2015, 90% of non-daily people who smoke who vaped believed e-cigarettes have been much less dangerous than smoking. That’s now lower than 50%. The end result? As an alternative of solely vaping, extra folks each smoke and vape.
“Dangerous misconceptions about vaping are holding folks again. We should prioritise focused campaigns to dispel myths and encourage full transitions away from smoking.”
Non-cigarette tobacco merchandise like cigars and waterpipes, traditionally uncommon in England, have additionally grown in reputation, significantly amongst vapers. These traits, coupled with the underreporting of non-daily smoking in official statistics, pose a big problem to England’s smoke-free 2030 goal.
In closing, Jamie Brown emphasised the necessity for strong public well being interventions. Supporting non-daily people who smoke – particularly vapers – to give up solely should be a prime precedence, alongside focused media campaigns to appropriate vaping misinformation. He concluded:
“The ‘final mile’ of tobacco management is proving extra complicated than we anticipated.”
Cochrane Overview proof: Updates on e-cigarettes for quitting smoking and rising proof on methods to give up vaping
Dr Nicola Lindson
Affiliate Professor within the Centre for Proof-Based mostly Drugs, College of Oxford
James Dunworth
The proof from Cochrane is obvious: e-cigarettes are more practical than Nicotine Substitute Remedy (NRT), resulting in an extra 4 profitable quitters per 100 folks. What’s extra, to this point the assessment has discovered no conclusive proof of better hurt related to e-cigarettes in comparison with NRT, though extra analysis is required.
One sudden perception is the sustained use of e-cigarettes amongst those that give up smoking with their assist. Cochrane information exhibits that six months after quitting, 70% of profitable quitters have been nonetheless vaping. Linsson recommended that this long-term use may really underpin e-cigarettes’ effectiveness, as many people who smoke fail to make use of NRT persistently or for a enough period.
What about those that need to finally give up vaping? Lindson launched ongoing work on a brand new assessment, one centered on interventions for quitting vaping. Preliminary findings from 9 research recommend higher-than-expected give up charges for vaping cessation—starting from 24% to 38%—in comparison with interventions for smoking cessation.
This raises an intriguing chance: May it really be simpler to give up vaping than smoking?
The US youth information helps this, displaying a dramatic decline in vaping prevalence in U.S. excessive colleges, from 27.5% in 2019 to 7.8% in 2023. That is unprecedented on the earth of tobacco and nicotine habit.
There’s a hazard – individuals who give up vaping may return to smoking, main Lindson to conclude:
“Quitting vaping shouldn’t result in a return to smoking, so we’d like evidence-based pathways for each people who smoke and ex-smokers.”
Efficient public well being safety wants sound scientific proof: The avoidance of unintended penalties
Prof Alan Boobis, OBE
Emeritus Professor of Toxicology & Chair, UK Committee on Toxicity, Imperial School London
James Dunworth
Though smoking’s prevalence has declined, it nonetheless accounts for 15% of UK deaths and prices public funds roughly £13.5 billion yearly. We nonetheless must encourage cessation and e-cigarettes have succeeded the place NRT fell brief – providing an efficient various to people who smoke via each organic and behavioral avenues.
What about flavours?
Thus far, proof has not proven that flavourings trigger vital adversarial well being results. The vast majority of the flavour compounds are additionally frequent in meals merchandise. We all know these is not going to be dangerous when absorbed into the our bodies. There’s the potential for hurt to the lungs, however publicity ranges are low. Flavour properties can change when heating, however that is additionally true when meals is cooked. Temperatures in vaping are additionally a lot decrease than in cigarettes.
The presenter additionally addressed high-profile well being scares, together with the 2018 U.S. EVALI disaster and ‘popcorn lung’, which linked common vaping with severe illnesses. These debunked myths create a disaster of credibility as a result of anybody can shortly discover out the reality.
In the end, the speaker argued that fears across the well being impression of flavourings are misaligned.
“[The real concern] is their attraction to younger, non-smoking demographics”. A nuanced method is essential – insurance policies should stability defending youth whereas guaranteeing people who smoke retain entry to efficient cessation instruments like vaping. Correct, science-based communication is essential to reaching this stability.”
“Poor danger communication has actual penalties. It’s important that public well being messages keep away from pointless panic whereas sustaining credibility.”
Half 2: Complicated issues, clumsy options and the courtroom of public opinion
Prof Sanjay Agrawal
Professor of Respiratory Science, College Hospitals of Leicester NHS Belief, Particular Advisor on Tobacco, Royal School of Physicians
James Dunworth
Prof Agrawal emphasised that vaping and tobacco management current intricate challenges formed by interconnected components like habit, twin use and youth uptake. These are “not binary issues,” and clumsy options – imperfect but viable – are sometimes the easiest way ahead.
The Royal School of Physicians (RCP) report presents 50 suggestions throughout 4 key areas: merchandise, worth, promotion, and buy. These suggestions goal to align nicotine product regulation with various well being dangers, recognising “nicotine as a part of the answer for cessation,” a stance that diverges from stricter nicotine-regulation insurance policies in different nations.
On merchandise, the RCP report requires enhanced standardisation of emissions, packaging, and labelling to enhance each security and transparency for customers. It additionally highlights the environmental impression of disposables, urging regulation to mitigate waste.
Value regulation was one other key focus. “Holding e-cigarettes reasonably priced for people who smoke whereas deterring youth uptake is vital,” stated Agrawal. Suggestions embody introducing measures similar to minimal pricing and bans on multi-buy presents. Nevertheless, he warned towards unintended penalties like cross-price elasticity, the place increased vape costs may push customers again to cheaper options like cigarettes – as noticed within the US.
Promotion and buy proposals tackled youth-targeted promoting and point-of-sale visibility, alongside endorsing enforcement of youth gross sales restrictions. Prof Agrawal was significantly vital of business affect, stating that tobacco corporations see youth vaping as “new entrants into the nicotine market” fairly than a harm-reduction software – making the elimination of business enter important.
Maximising advantages. Minimising unintended penalties
Dr Jasmine Khouja
Senior Analysis Affiliate, College of Bristol
Martin Dockrell
Tobacco Management Programme Lead, Workplace of Well being Enchancment & Disparities, (OHID)
James Dunworth
Dockrell started by acknowledging the dangers related to e-cigarettes, significantly amongst younger folks, Referring to the “4 Horsemen of the Tobaccalypse” – dying, illness, disparity, and dependence, he underscored the significance of cautious intervention design.
For instance, we are able to see from nations just like the US that there are confirmed methods to scale back youth vaping, similar to taxes and flavour restrictions. Nevertheless, these strategies have unintended penalties, similar to growing smoking charges.
“Even a really small enhance in smoking would utterly offset any advantages in lowering vaping as a result of vital hurt disparity between the 2.”
Dr. Khuja walked us via a “decision-making software,” designed to help policymakers with a snapshot of potential trade-offs. Utilizing this, the software suggests roughly 125,034 non-smokers within the UK are drawn into vaping via flavours. 48,784 would probably transition to smoking in consequence – however Khouja stated the key caveat is that this isn’t universally true” as there’s proof towards the gateway principle.
Then again, an estimated 460,200 grownup people who smoke may give up smoking by way of e-cigarettes if flavours stay accessible, with 381,102 grownup ex-smokers probably relapsing if flavours grew to become unavailable.
“In each estimations—whether or not trying solely at youth vaping or at youth who go on to smoke – proscribing flavoured e-liquids within the UK seems to have destructive penalties for public well being.”
The outcomes of interviews with 18-30s on how they’d react to a disposable ban have been significantly attention-grabbing:
“Many reported they’d smoke extra and even begin smoking as a result of it appeared “disgusting,” making it simpler for them to give up smoking than vaping. Others expressed pleasure about stronger and cheaper illicit merchandise changing into accessible, significantly from overseas. These responses spotlight the complexity of unintended penalties and underscore the necessity for continued analysis.”
To keep away from unintended penalties, policymakers should be guided by strong, ongoing analysis, and be certain that actions to curb vaping amongst younger folks don’t backfire by driving them – and adults – to cigarettes.
Or, as Dockrell put it:
“Cautious, research-informed coverage design is important to sort out dying, illness, and disparities with out creating new issues for public well being.”
Vaping & illicit medicine: Guarantees and pitfalls
Dr Tom Freeman
Director, Habit and Psychological Well being Group, College of Tub
James Dunworth
Freeman began by declaring that the primary hurt from hashish is from smoking and if folks vaped it as a substitute of smoking, it could be considerably safer. There’s a appreciable alternative right here.
We are able to check out Canada for instance. In a rustic the place hashish is authorized, vaping hashish is beginning to make a dent on flamable use. The significance of getting authorized, regulated gadgets accessible is demonstrated by the illness EVALI (brought on by way of unlawful hashish merchandise).
Hashish is a really protected drug when in comparison with tobacco, and we’re not going to see folks die from it. The scenario may be very completely different with artificial cannabinoids similar to spice, which may have very severe adversarial results – together with dying.
Sadly, these medicine have gotten prevalent within the UK. They’re now liable for half of all non-natural deaths in UK prisons, they usually have been present in over 70% of the UK’s colleges with extreme reactions being reported.
A part of the issue is that almost all younger folks suppose they’re shopping for hashish vapes (that are comparatively protected). Nevertheless, it’s tough to make hashish e-liquids and less expensive and simpler for the illicit market to make artificial cannabinoid vapes.
Issues are prone to worsen earlier than getting higher, with rising traits suggesting different medicine like Ketamine will likely be utilized in vapes. As issues evolve, it is going to be essential to contemplate the broader impacts of illicit drug use.
E-cigarettes for smoking cessation amongst folks experiencing homelessness (Challenge SCeTCH)
Dr Sharon Cox
Principal Analysis Fellow, Tobacco and Alcohol Analysis Group, College School London (UCL)
Dr Cox’s presentation highlighted the human actuality of smoking cessation – significantly amongst the homeless inhabitants. With homelessness up 10% in England within the final yr alone, she reminds us that, whereas 95% of homeless folks don’t ‘sleep tough’ open air, the bulk nonetheless report poor respiratory well being. This may be at the very least partly defined by the staggering smoking charges amongst the homeless inhabitants – 76% in comparison with 12.9% nationally.
Nevertheless, the constructive message is that fifty% of this group specific a want to give up.
The SCeTCH trial measured the impact of e-cigarettes as a smoking cessation help over 24 weeks with over 477 homeless contributors – with half receiving a vape equipment and e-liquid (EC group), and half receiving ‘typical care’ of an NHS give up smoking leaflet (UC group).
Eager to dispel the notion of homeless folks as ‘exhausting to succeed in’, Dr Cox emphasised that 277 contributors have been accessible for the 24-week follow-ups.
Outcomes confirmed that whereas give up charges remained low, the group given e-cigarettes confirmed increased reductions in cigarette use and seven-day give up charges, whereas ‘dangerous smoking behaviours’ have been diminished in each teams.
Nevertheless, Dr Cox was eager to emphasize that there’s a place for each methods in smoking cessation.“E-cigarettes maintain promise…however we are able to’t disregard the worth of typical care both”.
The presentation ended with a video that emphasised the real-world results of the trial, with contributors describing their private experiences and the advantages of switching – from smoking fewer cigarettes and higher respiratory well being to only smelling higher!
Understanding & addressing hurt perceptions
Dr Katie East
Analysis Fellow, Society for the Research of Habit (SSA) Griffith Edwards Tutorial Fellow, Nicotine Analysis Group, King’s School London
James Dunworth
Practically 70% of adults who smoke in England now incorrectly imagine that vaping is as dangerous or extra dangerous than smoking – a notion that has greater than doubled amongst youth over the previous decade.
The important thing contributors? Media sensationalism and deceptive public well being campaigns (significantly in the course of the EVALI outbreak). These began within the US, however at the moment are being adopted within the UK, significantly in locations like colleges. One other issue is a deep-rooted misunderstanding about nicotine’s function in well being harms. Dr East harassed that scare ways geared toward dissuading youth from vaping may backfire, as proof exhibits they do not yield long-term behaviour change and should perpetuate misinformation.
Misconceptions might deter youth vaping, however we don’t know if youths will take up smoking as a substitute. They’re additionally damaging for grownup people who smoke as they:
- stop people who smoke from switching to vaping
- hinder give up makes an attempt
- enhance the chance of smoking relapse.
Encouragingly, Dr East shared promising outcomes from a brand new intervention: TikTok-style movies that includes teachers debunking myths like “vaping causes most cancers.” A randomized trial with 600 younger adults confirmed these brief, evidence-based clips successfully improved correct perceptions within the brief time period, with some spillover advantages to associated beliefs.
Her conclusion? Tackling misinformation is important to assist hurt discount efforts, and modern, youth-focused methods like social media campaigns may very well be the way in which ahead.
Packaging, flavours and nicotine descriptions on nicotine and tobacco merchandise
Dr Eve Taylor
Analysis Affiliate, Nicotine Analysis Group, King’s School London (KCL)
James Dunworth
Eve Taylor’s presentation is value a quick point out, if solely to carry dwelling how excessive some present ideas are going. Her analysis appears not simply on the prospect of utilizing plain packaging and simplified packaging names however of doubtless changing flavour names with codes. She concluded:
“Analysis exhibits that standardising packaging – utilizing plain designs and simplified flavour names – reduces youth curiosity in vaping with out considerably deterring grownup people who smoke… Nevertheless, it could enhance youth misperceptions, main some to imagine vaping is as dangerous as smoking. ”
Panel Dialogue with Q&A: Figuring out efficient interventions to minimise unintended penalties
Chair: Prof Ann McNeill
Panel: Dr Jasmine Khouja, Martin Dockrell, Dr Tom Freeman, Dr Sharon Cox, Dr Katie East, Dr Eve Taylor, Alizée Froguel
James Dunworth
A mix of time and streaming points prevents us from protecting these panel discussions in depth. Nevertheless, one significantly attention-grabbing level got here from a Brazilian visitor who identified that 5 million folks in Brazil are utilizing unlawful vapes, as authorized vapes are banned.
What ought to they do, requested the visitor? “Legalise it”, stated Sharon Cox. Dr Tom Freeman additionally identified that the scenario is identical with hashish within the UK. In nations the place hashish is authorized, similar to in Canada, nations would not have issues with spice.
What subsequent for vaping within the UK?
Hazel Cheeseman
Chief Govt, ASH (Motion on Smoking & Well being)
James Dunworth
Half of UK people who smoke who’ve give up within the final 5 years did so by vaping. As vaping charges have gone up, smoking charges haven’t decreased as quick. There are a quite a few causes for this, together with:
- The notion that vaping is extra dangerous than smoking
- The concept that you’re simply swapping one habit for one more
- Worries over youth vaping spilling over into public area
- The notion that vaping is costlier
That is going within the mistaken course, and we have to do one thing to vary that.
Cheesman thinks we have to create a far much less seen marketplace for vaping. We have to:
- Scale back visibility of vaping to public with out damaging its attraction.
- Restrict how flavours are described and the way they’re displayed
- Make vaping about smoking cessation
- Attain folks by way of public well being campaigns and professionals
We additionally want to consider whether or not merchandise are protected sufficient, and if there’s extra we are able to do, as we now have a big group of people that simply vape, a few of whom haven’t smoked earlier than. We are able to all agree that vaping is much less dangerous than smoking, however how protected is protected sufficient?
Laws may assist make higher and safer merchandise, drive out rogue parts and provide options to vaping.
What’s going to occur if smoking is eradicated? We have to contemplate what people who smoke and ex-smokers will want sooner or later.
UK laws & enforcement
Craig Copeland
Head of E-Cigarettes, Healthcare, High quality and Entry Group, MHRA – The Medicines and Healthcare merchandise Regulatory Company
Kate Pike
Lead Officer for Tobacco and Vaping, Chartered Buying and selling Requirements Institute
Kayleigh Jenkins
Craig Copeland explains that the fast-moving, shifting traits of the previous yr have led to elevated challenges in vape regulation. Whereas a lower in disposable vape utilization has been constructive, regulators have confronted an inflow of recent options together with multi-tank and ‘2+10’ gadgets.
These merchandise confuse regulators as a result of they by no means conceived of or legislated for multi-tank merchandise, making it exhausting to say whether or not they’re authorized or not. ‘2+10’s’ with refill containers packaged alongside the gadget additionally muddle the idea of authorized separation – as they’re technically 2 notified merchandise that may be each compliant and non-compliant with regulators and with the market.
Measures taken to navigate these merchandise embody working with the CTSI Vaping Skilled Panel to make sure detailed steerage to enhance the submission course of – with necessities for schematics, packaging photos, utilization movies, and even bodily samples aiming to judge merchandise extra successfully and provides real-time suggestions.
From an enforcement perspective, Kate Pike explains that, whereas over 1.2 million unlawful vapes have been seized inland in 2023 alone (with many extra at ports and borders), together with vital efforts to scale back underage gross sales, vape enforcement nonetheless faces challenges when it comes to consistency.
The variety of particular person native authorities working inside regional budgets and priorities implies that, whereas some authorities lead aggressive crackdowns, some barely contact vaping regulation – resulting in an unbalanced enforcement panorama.
Buying and selling Requirements and regulators may solely work within the confines of the regulation and beneath the ability they’ve – unable at hand out fines or be liable for legal motion.
By way of new laws, Kate explains that a number of organisations together with Defra, Buying and selling Requirements and HMRC will work to offer readability and construction. Proposed measures embody extra enforcement officers being positioned to assist cut back the variety of unlawful merchandise available on the market, funding to assist retailers cut back waste in mild of the disposable vape ban and a licensing scheme to assist regulate the market and take away ‘dangerous actors’.
Disruptor, catastrophe, or distraction? Vaping and smokefree New Zealand
Ben Youdan
Director, ASH New Zealand
Kayleigh Jenkins
Ben’s annual replace on New Zealand’s formidable Smoke-Free objective confirmed nice progress – with an emphasis on the pivotal function performed by vaping. Boasting one of many world’s most quickly declining smoking charges, New Zealand is aiming to scale back every day smoking to only 5% by 2025.
Initially aimed to scale back smoking charges in Mauri communities, preliminary progress was sluggish. Nevertheless, previously 5 years charges have considerably diminished nationwide regardless of no main coverage interventions since 2018.
This downturn coincided with a big enhance in vaping – giving people who smoke an alternative choice to cigarettes and serving to to yield impressively diminished smoking numbers.
This was most important in Maori girls the place every day smoking numbers have virtually halved in 5 years, main Ben to state: “I don’t suppose I’ve ever seen such a speedy fee of decline in smoking for any inhabitants group anyplace on the earth,”
Different spectacular figures revealed that 27% of New Zealanders now stay in smoke-free (beneath 5% smoking charges) neighbourhoods, in comparison with simply 3% 5 years earlier.
This correlation between elevated vaping and diminished smoking is simply too robust to disregard….however why aren’t we celebrating? Why is New Zealand’s stop-smoking success not international information?
Ben attributes this to political disruption, a fixation on youth vaping and “hurt discount insurance policies being painted as tobacco business conspiracies.”
Put up Basic Election, the repeal of anti-cigarette legal guidelines that championed vaping as a cessation help in March 2024 led to mass protests and accusations of tobacco business affect on coverage.
Regardless of a downturn in youth vaping and smoking, these statistics not often make the headlines or are utterly ignored, with the press extra prone to give attention to the hazards of nicotine.
Ben concludes with plans for the longer term – with an imminent new invoice seeking to assert new measures together with disposable vape bans, elevated penalties for underage gross sales, promoting restrictions and extra.
Lastly, Ben questions whether or not New Zealand can attain Smoke-Free 2025:
“We are able to, IF we behave ourselves… [but if we] give attention to ideological variations fairly than public good, we danger sabotaging ourselves.”
Ben concluded with a name to remain centered on what issues: saving lives.
Australia’s distinctive nicotine regulatory framework – can mild contact medicines regulation work?
Prof Coral Gartner
Professor, College of Public Well being, College of Queensland, Australia
James Dunworth
Professor Gartner coated Australian vaping laws in painstaking element – an excessive amount of element to cowl right here. The important thing issues to know are:
Australia used ‘mild contact’ (learn brutal) drugs laws to control and permit entry to vaping. It didn’t work – youth vaping elevated and almost 90% of vapers now purchase vapes illegally. So Australia is now making an attempt harsher laws, which additionally don’t appear to work.
EU Laws: Vaping, pouches & flavours
Pablo Cano Trilla
Head of Authorized Evaluation, ECigIntelligence
James Dunworth
Pablo confirmed that fruit, beverage, and candy flavours dominate vapers’ preferences globally, whereas tobacco-flavoured choices are considerably much less widespread. Within the U.S., for instance, only one% of vape merchandise are tobacco-flavoured, with comparable traits noticed throughout different markets, together with nicotine pouches.
However what occurs when flavours are banned? Proof from nations like Lithuania and the Netherlands paints a fancy image. Whereas bans on home gross sales have diminished availability regionally, they’ve fueled cross-border purchases and on-line imports, undermining enforcement efforts and shifting tax income to neighbouring nations.
The EU faces a pivotal second. Proposed flavour bans and outright restrictions on nicotine pouches spotlight stark regional divides. Nordic nations like Sweden advocate regulation, emphasizing the function of different merchandise like snus in lowering smoking. In the meantime, nations like France lean in direction of prohibition, elevating questions on entry to harm-reduction instruments.
In the end, the info underscores that flavours are important for vape customers, with bans possible driving unintended penalties fairly than assembly public well being aims.
U.S children not smoke. Why aren’t we celebrating?
Prof Kenneth Warner
Avedis Donabedian Distinguished College Professor Emeritus and Dean Emeritus, College of Public Well being, College of Michigan
James Dunworth
Adolescent youth smoking has principally disappeared. It’s one of many best public well being achievements within the US. Each day smoking has gone from 1 / 4 of highschool seniors to 0.7%. That is the smoke-free technology, however nobody has paid any consideration to it.
What brought on this?
A few of it’s possible right down to modifications in social norms and insurance policies. However what about vaping? We are able to’t know for certain, however Professor Warner thinks it was an element, highlighting the speedy enhance in cessation after vaping had been launched.
Why aren’t we celebrating?
As a result of there’s a concern about tobacco and nicotine use in any type. In the event you imagine smokeless tobacco is as harmful as combustibles (which most Individuals do) that is problematic. Plus, most Individuals imagine nicotine is the reason for smoking illnesses – together with US docs.
Then there’s the particular case of e-cigarettes. Initially there was a worry of renormalising smoking, however the reverse has occurred. Nevertheless, mother and father, academics and others are nonetheless anxious in regards to the risks of vaping, particularly as vaping has been taken up by extra rich, educated white college students.
Evaluating the fears
Habit – That is prone to be far much less prevalent amongst e-cig customers.
Damaging younger brains – This worry relies on animal laboratory research which are 20-30 years previous. Why are we listening to about it now once we are speaking about a lot much less harmful merchandise than when children have been smoking?
Youth vaping: Nicotine vaping peaked in 2019 at almost 20% however has now plummeted to round 5.9% Each day vaping can also be plummeting, in 2023 lower than half what it was 4 years beforehand.
Have we received?
We’ve received a significant battle towards combustion, however smoking may come again. The present technology may have considerably decrease ranges of sickness and dying together with most cancers, coronary heart illness and COPD. Smoking stays an issue for adults, particularly for deprived teams.
When unintended penalties are the primary consequence: Rethinking regulation
Clive Bates
Director, Counterfactual Consulting Ltd
James Dunworth
Summit organiser Amanda thoughtfully positioned Clive Bates close to the top of the day – I believe as a result of after hours of listening to generally sophisticated and definitely mentally tiring shows, Clive all the time manages to wake folks up.
Bates began by reminding us why folks use nicotine; it’s a psychoactive drug that’s immensely widespread and makes folks really feel like they’re feeling higher. It explains why nicotine is so widespread, and why that demand is just not going away and can’t be wished away.
Tackling the theme of unintended penalties, Bates argued that these usually are not merely peripheral points – they’re central to the effectiveness (or failure) of tobacco regulation.
His key message? Insurance policies that fail to account for behavioural responses danger inflicting extra hurt than good.
“If smoking is 20 instances as harmful as vaping you’ll be able to’t simply say, ‘Properly, we have saved a little bit of vaping, we have brought on a bit extra smoking.’ The web hurt is big.”
Bates underscored the significance of understanding that nicotine use, overwhelmingly an grownup phenomenon, is not going to merely “disappear” via wishful coverage.
He categorised unintended penalties into three areas:
- Opposed behaviour change: Laws that push folks again to smoking – similar to vape bans or tax hikes – symbolize a public well being setback. For every vaper who returns to smoking, the online hurt skyrockets.
- Illicit commerce: Prohibition fuels black markets, which not solely lack oversight but additionally typically draw younger folks into harmful provide chains.
- Workarounds: When laws tighten, innovation persists. From unlawful flavourings to DIY vape kits, the panorama adapts, typically undermining security.
Bates warned that outdated approaches to tobacco management not work in a world reshaped by globalization, social media, and speedy innovation.
“The instruments we had within the ‘80s and ‘90s have been designed for advertisements, factories, and cigarettes. Now we’re up towards encrypted communications, cryptocurrency, and billions of social media customers.”
He illustrated international coverage failures, together with Australia’s thriving underground vape market beneath stringent laws (94.5% of vapes imported illegally) and equally the US’s incapability to curb unregulated vapes regardless of FDA oversight. Within the UK, the 1992 snus ban painfully highlighted what’s at stake – denying entry to a confirmed harm-reduction product.
On the proposed generational smoking ban, he remained sceptical. Regardless of being hailed as “historic,” Bates deemed its public well being impression negligible, with advantages unlikely till 2044. “As 80,000 folks die yearly from smoking-related illnesses, saving 2,000 lives over a decade is merely a drop within the ocean.”
His options? Threat-proportionate regulation, sustaining lawful markets, accountable advertising and marketing, age-secure retailing, and, critically, defending kids – not simply by stopping youth vaping however by serving to mother and father give up smoking. Bates concluded with a transparent plea:
“Let’s suppose pragmatically. Those most in danger want smarter, measured policymaking.”
The place nice alternatives met actuality. Classes from the U.S. regulatory expertise
Jeff Weiss
Author & Commentator, Former Chief Engagement Officer of NJOY
James Dunworth
Jeff delivered a searing critique of the U.S. regulatory method to nicotine vaping merchandise, singling out the FDA’s dealing with of pre-market tobacco functions (PMTAs). Regardless of being 4 years into the regulatory course of, simply 9 merchandise have been approved. In stark distinction, 90% of the U.S. vaping market operates illicitly and misinformation about vaping continues to erode public understanding.
“Alarmingly, solely 10% of respondents within the U.S. accurately determine nicotine vaping merchandise as much less dangerous or a lot much less dangerous than smoking.”
Conley juxtaposed the FDA’s stringent regulation of vaping merchandise with its lax stance on flamable tobacco, noting that menthol stays a lawful cigarette flavour. He accused the FDA of failing to fight misinformation with the identical vigour it applies to different public well being points.
Conley traced this failure again to 2018, when issues about youth vaping derailed a promising nicotine hurt discount technique. Youth vaping charges soared, prompting then-FDA Commissioner Scott Gottlieb to name it an “epidemic.” Including gasoline to the backlash, Michael Bloomberg launched a $160 million marketing campaign focusing on flavoured vaping merchandise. Conley argued that Bloomberg’s affect successfully dismantled the hurt discount consensus constructed over a long time, changing it with insurance policies that misrepresented vaping as equally harmful as smoking.
“Even after youth vaping charges fell beneath pre-2017 ranges, Bloomberg awarded one other $140 million to proceed his marketing campaign. The discourse has shifted, with e-cigarettes dismissed as merely buying and selling one dangerous habit for one more.”
This U.S.-centric problem, Conley warned, is cascading globally. Misinformation originating within the U.S. has contributed to 50% of U.Okay. adults incorrectly believing vaping is as dangerous as smoking. Bloomberg’s technique even extends to the WHO, whose tobacco management insurance policies now align together with his anti-vaping stance.
So, how will we chart a brand new course? Conley referred to as for a return to public well being rules grounded in science, fact, and hurt discount.
“Are we troopers in a struggle towards a despicable enemy, or are we rescuers aiming to avoid wasting lives? A struggle mentality tolerates misinformation and collateral injury. A rescuer mindset prioritizes science and saving lives. This distinction is vital.”
Lastly, Conley emphasised the necessity for impartial oversight to guard tobacco management insurance policies from all vested pursuits—not simply business gamers. For significant progress, he concluded, regulators should reground their efforts in science and consensus, shedding the polarizing struggle narrative that presently dominates.
Accelerating the top of smoking
Prof Robert Beaglehole
Emeritus Professor, College of Auckland, New Zealand & Chair ASH – Motion for Smokefree 2025, NZ
Kayleigh Jenkins
A harm-reduction advocate for nearly 50 years, Professor Beaglehole’s presentation focussed not solely on the worldwide disaster brought on by smoking, however the progress being made and the pressing options wanted.
With smoking nonetheless claiming lives, Prof Beaglehole emphasised that ‘enterprise as typical’ is not going to remedy the issue. Regardless of progress being comprised of the likes of the Framework Conference on Tobacco Management, limitations nonetheless stay.
International targets lack ambition and are nonetheless falling brief on addressing power sickness charges, whereas key interventions similar to elevated tobacco tax stay underutilised.
Arguing for integrating hurt discount into international methods, Beaglehole factors to success tales from New Zealand, Sweden, and Japan and encourages the WHO to recognise the function of hurt discount in ending smoking.
Ending on a private observe, Prof Beaglehole cited his 4 grandsons as his motivation to see a smoke-free future. A problem that’s immense – however achievable.
Closing Keynote: Actual folks residing in actual communities: Are we doing sufficient to make a smoke-free future a actuality for everybody?
Ailsa Rutter OBE
Director, Contemporary and Stability
Kayleigh Jenkins
After a convention stuffed with scientific research and statistics, Alisa Rutter’s highly effective closing keynote tackle was the proper approach to finish this yr’s summit – reminding us of the actual world, human value of tobacco use and the explanations hurt discount teams exist.
Representing Northeast England’s FRESH tobacco-control organisation, Ailsa displays on the Northeast’s decade-long management in tobacco management and the successes seen. The area has skilled the biggest drop in smoking charges and, based on APS information, now boasts the second-lowest smoking charges within the nation.
Speaking of Contemporary’s foremost targets Ailsa acknowledged “We would like as many people who smoke as doable to offer quitting a go yearly, utilizing the simplest, evidence-based strategies.” and named vaping as a vital software in a multi-system method to quitting.
Nevertheless, regardless of this progress, there’s nonetheless stark inequality – with the toll of tobacco use nonetheless principally affecting probably the most deprived teams.
This was highlighted in a collection of emotional movies depicting the real-life tales of those that had misplaced mother and father to smoking. Drawing on her personal expertise of dropping her father to COPD, Ailsa emphasises the significance of private tales in driving change.
With such an emphasis on the hazards of youth vaping, it was each sobering and vital to listen to a speaker talk about the impression of smoking on kids and households.
“That is about households. I don’t ever need children to lose their mother and father too quickly. I would like mother and father and carers to stay lengthy, glad lives—not only for themselves however for his or her households.”
There’s a troubling disconnect between the proof offered at this (and different summits) and the insurance policies the UK is shifting in direction of. To summarise, we’ve been informed:
- Vaping is 20 instances safer than smoking, and there’s no proof it causes smoking illnesses similar to lung most cancers.
- Youth vaping is growing, however smoking charges amongst each adults and youngsters are plummeting. The USA’s and New Zealand’s experiences provide hope that youth vaping will fall.
- Vaping is much less addictive than smoking.
- Vaping is more practical than NRT and is concerned in 50% of give up makes an attempt.
But on this nation, we’re contemplating banning flavours, introducing plain packaging and placing a tax enhance on vaping (whereas on the similar time growing the price of smoking by a paltry 2p per cigarette). Audio system from this yr’s summit estimate simply considered one of these measures will result in lots of of 1000’s of extra people who smoke.
Just a few weeks in the past, I discussed to a colleague that I missed the times once we may really feel like heroes. Again then, we have been serving to 1000’s of individuals swap from smoking to vaping. And the tales we heard again from our prospects have been heartwarming – with individuals who may barely stroll up the steps capable of breathe higher, begin exercising and even operating once more.
These days, I dread the query of “What do you do for a residing?” To say you’re within the vape business immediately labels you a pariah, a peddler of hurt fairly than an agent of change.
It’s an indication of the instances, and a part of the reason being that too few folks hearken to specialists who care in regards to the science and the hurt brought on by smoking. For that cause, I’m immensely grateful for Amanda’s annual efforts in placing the E-Cigarette Summit collectively and offering at the very least one avenue for sincere and knowledgeable debate to happen.
