The United Kingdom will be offering free nicotine vape kits to one million people who smoke cigarettes. Nothing like this has ever been done on such a scale, and the move solidifies the UK’s reputation as a world leader in tobacco harm reduction.
On April 11, a government press release stated that almost one in five people who smoke in England will be “provided with a vape starter kit alongside behavioral support,” to encourage smoking cessation in a “world-first” national “swap to stop” scheme.
Additionally, people will be offered up to £400 in vouchers as an incentive to quit smoking during pregnancy, plus “behavioral support.” Pilot schemes for this approach—which includes the option of switching to vapes, as the UK’s National Health Service recommends for those who find it helpful—have been deemed successful. According to the press release, “supporting more women to have a smoke-free pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care.”
Estimated to cost £45 million, the entire scheme will be rolled out over two years. Local authorities are being invited to join the first wave of areas to participate, and will be able to decide which population groups to prioritize. Smoking rates are highest among low-income and marginalized communities, where British councils have already been focusing cessation efforts.
Other initiatives published in the Department of Health and Social Care press release include “mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.” That sounds like a contrast to the customary graphic warning labels, which critics have described as stigmatizing.
A government-commissioned review last year stated that “the government must embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco.”
An “illicit vapes enforcement squad,” costing £3 million, will also be created to “tackle illicit vapes and underage sales.”
Despite the country generally welcoming vapes, media and political alarm over youth use—particularly of disposables, which some want to ban—has been rising. Filter recently reported how some British schools have taken extreme anti-vaping measures. But regular vaping among UK youth who’ve never smoked remains rare, and youth are now less likely to try cigarettes than ever before.
The government’s goal, reaffirmed last year, is to make the UK “smoke-free” (under 5 percent prevalence) by 2030. England’s smoking rate in 2021 stood at 13 percent—the lowest yet recorded, but far short of the target.
The new plan follows a government-commissioned review by Dr. Javed Khan, which last year stated that “the government must embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco.”
It was Public Health England (then a UK government agency), which commissioned a 2015 independent review that found vaping to be about 95 percent less harmful than smoking. Much other evidence has shown reduced harms, as well as vapes’ superior efficacy for smoking cessation compared with NRT.
Other recommendations from the Khan review, such as raising the legal age for purchasing cigarettes—a policy which New Zealand has adopted, not without controversy—have been rejected. According to the Independent, “Health minister Neil O’Brien said policy will focus on ‘helping people to quit’ rather than imposing bans, despite pressure from campaigners and MPs.”
“All in all, it seems like a good day for health and health disparities in England.”
The government’s overall plan has been broadly welcomed, though with some reservations. Deborah Arnott, chief executive of the Action on Smoking and Health (ASH) charity, told the BBC that “Vapes increase smokers’ chances of successfully quitting, as do vouchers for pregnant smokers, so these are welcome steps in the right direction, but they are nowhere near sufficient.”
Sarah MacFadyen of Asthma and Lung UK also doubted that “swap to stop” would be enough to meet the 2030 goal, adding, “What smokers need is stop smoking services offering personalized support.”
But Clive Bates, a former director of ASH, told Filter that the measures “hit exactly the right note.”
Supporting promotion and provision of vapes as harm reduction, he expressed relief that the government had “avoided pointless or counterproductive gesture policies like bans on flavors, bans on disposables, or bans on vape marketing” that might have resulted from policymakers “losing their minds over youth vaping.”
Instead, Bates said, they seem to have opted for gathering “evidence on what might work without unintended consequences that end up making everything worse.”
“All in all,” he concluded, “it seems like a good day for health and health disparities in England.”
The UK has now adopted more vaping policies that set it apart from many other nations—including the United States’ politicized regulatory quagmire and local bans, as well as outright bans in countries like India, Thailand and Argentina.
An estimated 4.3 million people in Britain vape, most of whom switched from cigarettes, and it now looks even likelier that their numbers will continue to swell rapidly. The public health outcomes of a transition on this scale will be there for the world to see.
Photograph by Matt Trostle via Flickr/Creative Commons 2.0
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