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Adam Smith Institute report suggests if vaping replaces smoking Britons could save 1 million life years but young women risk being left behind.

• Average smoker will lose a decade of life expectancy and have lower life quality compared to non-smokers
• Access to alternatives and information on health risks key to switching from smoking but currently held back by domestic and EU rules
• UK’s liberal harm reduction approach to vaping has worked to cut smoking but lifting EU legislation post Brexit could help more people kick the smoking habit.
• Young women are being left behind by the vaping revolution and are risking their lives smoking
• If women under the age of 24 vaped at the same rate as young men Britons could save over a million years of life

Reforms to laws that discourage switching from cigarettes to vaping could help save over a million years of life, a new paper by the Adam Smith Institute claims today with young women standing to gain the most.

Despite the overwhelming majority of UK smokers knowing the risks of smoking large numbers continue to smoke.

Young women risk being left behind as other groups move to vaping. While 8.9% of young men vape, for women it is just 2.6%. Women are however continuing to smoke with nearly 16% of women aged 16-24 smoking.

Data from the BBC’s Reality Check team revealed that vaping shops are the third largest growth sector in retail space in the UK, with 381 stores opening in 2017. Yet despite the rise in shops on high streets, vaping remains a predominantly male activity, especially among the young. While women continue to smoke they increase their exposure to carcinogenic chemicals which are heavily linked to respiratory diseases and cancers.

The paper uses World Health Organisation estimates of additional life expectancy from quitting smoking at different ages and Public Health England estimates of e-cigarette relative risk to estimate that 1,036,640 years of life could be saved if young women vaped at the same rate as young meng. In the United States estimates suggest wider adoption of e-cigarettes by smokers could lead to at least 1.6 million fewer premature deaths and 20.8 million fewer life years lost.

Despite Public Health England’s recent advice that e-cigarettes are at least 95% safer than cigarettes, the majority of smokers across the UK do not believe that e-cigarettes are less harmful than cigarettes and this situation has got worse over time. Even fewer are aware of the existence of newer reduced-risk products like "heat-not-burn" devices, warns Daniel Pryor of the Adam Smith Institute.

Daniel Pryor of the Adam Smith Institute argues that sensible reforms after Brexit to advertising restrictions, many of which were put in place at the European Union level, could mean fewer lives lost to smoking related illnesses in Britain.

Both vaping and heat-not-burn technology could be advertised directly to smokers within cigarette packaging, on online platforms and with reference to Public Health England’s advice on the benefits of swapping from smoking. While larger vaping liquid sizes, currently restricted by EU Single Market rules could be reformed to make it easier to ensure access to liquids and reduce the temptation to slip back into standard cigarettes.

Some reforms could happen at home now. The new report argues that Britain should look again at bans on indoor vaping in public places, on rail platforms and other shared spaces. This builds on calls from the British Lung Foundation to ensure e-cigarettes aren’t “banned in enclosed public spaces by legislation as smoking is.”

Reduced-risk alternatives to smoking matter, Sweden has one of the lowest smoking and cancer rates in Europe – linked to the prevalence of snus – which studies have shown to have little impact on life expectancy. In Japan, where heat-not-burn technologies are both openly advertised market share is now up to 10% of nicotine products and cigarette sales have plummeted by 12.4% in the past year.

Lack of alternatives matter too. In Australia, where e-cigarettes are banned, smokers as a proportion of the population dropped by just 0.6 percentage points between 2013-2016 (the last dataset available).

The UK by contrast saw a fall of 2.9 percentage points – and there are now more ex-smokers who use e-cigarettes than current smokers. The UK’s mostly liberal approach over the past decade has been a large part of the success of lower smoking rates and higher vaping rates, the report argues.

If Britain is to achieve a continued fall in smoking rates then more liberalisation for reduced risk alternatives is key.

Daniel Pryor, Research Economist at the Adam Smith Institute and author of the paper, said:

“To its great credit, successive UK governments and public health bodies have maintained a comparatively liberal approach to vaping and other consumer nicotine products. Domestic and international evidence shows that the health benefits of this harm reduction approach are enormous, but young British women who smoke are being left behind.

“It’s vital that we combat the widespread and worsening misperception that vaping is as harmful as smoking through sensible advertising reforms and public health guidance. We must also ensure that smokers who hold strong preferences for tobacco have viable quit options by making it easier to bring other innovative reduced-risk products (such as ‘heat-not-burn’ devices) to market.”

Sophie Jarvis, Policy Advisor at the Adam Smith Institute, said:

“Women are being left behind by the vaping revolution. And it’s costing them years off their lives. The EU’s ban on advertising stifles innovation and is holding back people from switching from harmful cigarettes. As we leave the EU we have the chance to scrap these bans and save lives - in particular women’s lives.”  

Dr Roger Henderson GP, a leading smoking cessation expert, said:

“Smoking is the single biggest cause of preventable early death and illness in England, with around 100,000 deaths in the UK attributable to smoking each year.

“In my surgery, increasing numbers of smokers are telling me they are trying e-cigarettes as an aid to cutting down smoking or quitting, we shouldn’t ignore them. Let’s save lives by making it easier to market safer nicotine products. It may be nicotine that makes it hard for smokers to quit, but it is smoke and tar that puts them in the ground.”

Notes to editors:

For further comments or to arrange an interview, contact Matt Kilcoyne, Head of Communications, matt@adamsmith.org | 07584 778207.

The report ‘1 Million Years of Life’ is available here.