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What do the experts say about the safety of e-cigarettes?

13/11/2015 | By Freedom Health Insurance
In the past few years, vaping – the use of e-cigarettes – has become more popular. Action on Smoking and Health (ASH) estimates that in the UK today, there are 2.6 million adults using electronic cigarettes (1), and the amount of current smokers who also use the devices has risen from 2.7% in 2010 to 17.6% in 2014 (1).

Some people say that e-cigarettes are a helpful way to stop smoking, while others have doubts about their effectiveness as an aid to quitting, and are concerned about the amount of research that they feel still needs to be done.

Opinion is divided on this issue with a number of interested bodies weighing in on each side of the argument, but the issue is complex.

Less harmful, but not risk-free?

Public Health England (PHE) released a review in August 2015 stating that e-cigarettes are probably around 95% less harmful than tobacco (2). The report also concluded that so far, there is no evidence that using electronic cigarettes could be a gateway into smoking tobacco for children, or non-smoking adults (2).

The Director of Health and Wellbeing at PHE, Kevin Fenton, pointed out that e-cigarettes are not completely risk-free, but “when compared to smoking, evidence shows they carry just a fraction of the harm” (2). Fenton has also said that it is necessary to continue to study the long term effects of e-cigarette use (3).

He adds that the widespread opinion that e-cigarettes are at least as harmful as tobacco could keep many people from quitting, and that e-cigarettes should be used by services that help people to stop smoking (2).

Action on Smoking and Health (ASH) welcomed the report, stating that many of the 8 million smokers in England would benefit from switching to e-cigarettes, but that “unfounded health concerns” could have put them off from making the change (4).

The Royal College of Physicians also welcomed the publication, saying that e-cigarettes will help “save lives (5)” and may help people who have not been successful in trying to quit smoking using other methods.

Further research

Professor Linda Bauld from Cancer Research UK (CRUK) also stated that the organisation recognises that e-cigarettes may offer potential benefits for people who want to quit smoking, but added that CRUK is funding further research into the long term impact of the use of electronic cigarettes (2).

Concerns and better regulation

The British Medical Association (BMA) has stated that the effectiveness of e-cigarettes as a way to quit smoking has not been conclusively proven, and that the variability of elements used in e-cigarette vapour is concerning (6). It also called for stronger regulation of e-cigarettes (7).

A report published in 2014 by the World Health Organisation (WHO), also concludes that e-cigarettes should be regulated in order to be able to judge the effects of their use and so that adequate research can be conducted (8).

Martin McKee at the London School of Hygiene & Tropical Medicine, and Professor Simon Capewell at the University of Liverpool, have jointly published an article in the British Medical Journal (BMJ) which also questions the quality of the evidence in the PHE report (9).

McKee and Capewell say in their article that e-cigarettes should not be viewed only in comparison with conventional cigarettes but also in contrast with non-smokers, expressing concerns about the uptake of e-cigarettes among children and adolescents who would not smoke otherwise (9).

In addition, the authors were concerned by the fact that the 95% figure in the headline of the PHE report came from one meeting involving 12 people, several of whom could potentially be biased in favour of e-cigarettes (9).


With the debate still ongoing, it may be some time before the bodies and individuals mentioned above come to any form of agreement about the use of e-cigarettes. The issue is a complex one, and we should probably expect more research emerging in the future.

1. ASH. Use of electronic cigarettes (vapourisers) among adults in Great Britain [Online] Available here.
2. GOV.UK. E-cigarettes around 95% less harmful than tobacco estimates landmark review [Online] Available here
3. GOV.UK. E-cigarettes: a public health response [Online] Available here
4. ASH. ASH welcomes clarity from Public Health England on the safety of electronic cigarettes [Online] Available here
5. RCP. RCP welcomes evidence review on e-cigarettes [Online] Available here
6. BMA. Tobacco: E-cigarettes [Online] Available here.
7. BMA. Vaping needs stronger regulation, say doctors leaders [Online] Available here.
8. FCTC. Electronic nicotine delivery systems Report by WHO [Online] Available here.
9. BMJ. Evidence about electronic cigarettes: a foundation built on rock or sand? [Online] Available here