With reports that ministers have not ruled out plain packaging for vapes or banning the flavoured versions, the dial on the products appears to be shifting in England.
The moves reflect fears that growing numbers of children and young people are becoming addicted to nicotine and risking lung damage by taking up vaping.
In the UK, vaping has long been valued as a useful smoking cessation tool, and it is easy to buy vapes, which usually contain nicotine but do not have tobacco in them. But other countries are increasingly opting for tougher stances.
In Australia, recreational vaping is banned and vapes are now available only on prescription, in response to fears that their use can lead to nicotine addiction. The Netherlands has banned flavoured vapes and France is considering banning cheap disposable vapes.
Peter Hajek, a professor of clinical psychology at Queen Mary University of London, says the public health benefits of vaping as opposed to smoking should be remembered as it represents the “best chance we ever had of getting rid of cancer, lung disease and heart disease caused by smoking”.
He is sceptical about some of the debate on children vaping, which he views as youthful experimentation, with daily vaping among those who have never smoked rare. “The main effect has been in deflecting young nicotine seekers from smoking,” he said, noting that smoking among young people has been declining “significantly faster” in the UK and US, where regulation on vaping is looser, than in Australia.
He says the tenor of the discussion reminds him of calls in previous centuries to ban caffeine or make it available only on prescription, “pointing out various imaginary risks to youth”, and is an example of the “powerful voice of moralists”.
Restricting vapes to prescription only while cigarettes remain available in any corner shop could also send a confusing message about harm, according to the campaign group Action on Smoking Health (Ash). “It would make it much harder for adults to vape than to smoke and could even lead some vapers to go back to smoking,” said its deputy chief executive, Hazel Cheeseman.
Ash and many experts believe that although an outright ban is not the answer, there needs to be stricter regulation and enforcement around disposable vapes, which are especially popular with young people, including taxes to make them more expensive. Ministers are also reportedly considering calls for plain packaging, mirroring tobacco rules, and a ban on marketing targeted at children.
Vapes are not covered by rules governing tobacco marketing and ministers are already planning to close a loophole that lets retailers hand out free samples to young people.
Jamie Brown, a professor of behavioural science and health and director of the tobacco and alcohol research group at University College London, says there is a delicate balance to be struck between “maximising the opportunities for adults to quit and minimising risks of people who have never smoked, especially children, from using them.”
He notes that smoking cessation medications, which in the UK are available only by prescription, have never been as widely used as vapes. Conversely, there is a strong body of evidence supporting the idea that vapes help people quit smoking: the UCL smoking toolkit study shows that tens of thousands of people have stopped smoking each year since 2013 by switching to vapes.
But some health experts are concerned by the emerging evidence of the long-term risks of vaping, combined with the fact there are not enough clinical studies to fully understand its impact. “Vaping is perceived by many as a safer alternative to smoking; however, is ‘safer’ the same as ‘safe’?” said Deirdre Gilpin, a senior lecturer at Queen’s University Belfast.
She points out that the evidence suggests vaping is most effective as a smoking cessation tool in a “well-controlled, supportive environment, such as might be achieved were vapes to be part of a prescription-based smoking cessation programme”.
Daniel Sgroi, a professor of behavioural economics at the University of Warwick, says his team have been looking into a “largely ignored” aspect of vaping: dual use with cigarettes, in which people vape where smoking is banned but continue smoking elsewhere.
“Combined with the well-established role of vaping as a gateway into smoking, particularly for the young, and the growing evidence of medical risks associated with vaping, this explains why so many countries are now treating vaping with caution,” he said.
