Survey shows most smokers do not know e-cigarettes are less harmful than smoking

Action on Smoking and Health (ASH) welcomes the launch of a consultation by the National Institution for Health and Care Excellence (NICE) on revised tobacco guidance, including updated advice for healthcare professionals on what to say to smokers about vaping. Ralph, aged 59, is a good example of the difference such support can make. A smoker since his early teens, he decided to stop smoking during the first lockdown in 2020, having tried to quit before but never succeeding for long.

For him, e-cigarettes alongside advice from health professionals made all the difference. He started using his e-cigarette before meeting with a stop smoking advisor and they supported his choice and provided him with further medication and support, “It was really helpful that the stop smoking advisor was supportive when I said I was trying vaping. I’d found a vape with a sealed capsule that worked for me. It doesn’t leak, it’s quite small and unobtrusive and doesn’t produce loads of vapour. It just gives me a little nicotine hit when I need it. It’s not the same as smoking but it does give you something to do with your hands. Vaping’s made the difference for me, after decades of smoking, finally I’ve been able to quit.”

NICE guidance is needed, because despite being a proven aid to quitting and more effective than nicotine patches or gum, 30 per cent of smokers have never tried e-cigarettes; equal to around 1.7m people in England. Additionally, only one in ten smokers (12 per cent) surveyed by YouGov for ASH know that e-cigarettes are much less harmful than smoking. Of the remainder, a third (32 per cent) think they are more or equally harmful, one in four (24 per cent) do not know and 30 per cent think they are less harmful, but do not realise that they are a lot less harmful.

Deborah Arnott, chief executive of ASH said, “With support and encouragement from health professionals, more smokers would use an e-cigarette to help them stop, increasing the overall number who successfully quit long-term. This would be another step forward to securing the government ambition for England to be smoke-free by 2030.”

Misconceptions of risk
Since 2013 the fallacy that e-cigarettes are equally or more harmful than smoking has grown from 7 per cent to 32 per cent in 2021. In reality, e-cigarettes pose much less of a risk to health than smoking.

When asked why they have not used an e-cigarette, 10 per cent cite concerns about safety and a further 22 per cent say they are concerned about substituting one addiction for another. Both concerns indicate a misunderstanding of the positive role e-cigarettes can play in helping smokers quit.

Level of use
ASH and King’s College London estimate that in 2021, there are around 3.6m current vapers in Great Britain. This is the same number as in 2019, following a dip in use to 3.2m in 2020. The numbers of people vaping have been fairly static in the last few years, after a big increase in popularity between 2013 and 2015.

Youth use
While e-cigarettes are now a proven route to quit for adult smokers, there have been concerns that young people will use the products as a route into smoking. ASH monitors use annually and will continue to do so, but to date survey findings show low levels of use among 11-17 year olds (the age of sale for e-cigarettes is 18).  Fewer than 1 per cent of 11-17 year olds who have never smoked are currently using an e-cigarette and only 3.3 per cent have tried them. The overwhelming majority of all 11-17 year olds have never tried an e-cigarette, and this has seen little change since 2015 (in 2015 the proportion was 87.5 per cent of 11-17 year olds and in 2021 it was 88.2 per cent).