For the first time, the number of adults using e-cigarettes in Great Britain has exceeded the number of traditional cigarette smokers, according to official figures. The shift marks a significant turning point in the nation's relationship with nicotine.
The New Landscape of Nicotine Use
Statistics released last month by the Office for National Statistics (ONS) reveal a clear trend. 5.4 million adults aged 16 and over now vape daily or occasionally, compared to 4.9 million who smoke cigarettes. This data confirms vaping as the UK's dominant method of nicotine consumption, a status bolstered by its greater social acceptability compared to smoking.
However, this milestone is accompanied by growing concern. Many vapers report a strong desire to stop or reduce their usage, finding the habit more stubborn to break than anticipated. Some even contemplate a return to traditional cigarettes, which, despite their well-documented dangers, were less convenient for constant, discreet use.
Navigating Risk and Misinformation
Public health experts warn that confusion over the relative risks of vaping may be exacerbating the problem. A survey by the charity Action on Smoking and Health (ASH) in September found that 63% of young people believe vaping is as harmful as, or more harmful than, smoking.
This perception contradicts decades of scientific evidence. "We can be absolutely confident that vaping is far less harmful than smoking," stated Martin Dockrell, the recently retired tobacco evidence lead at the UK's Office for Health Improvement and Disparities. The key difference is combustion; cigarette smoke contains tar, carbon monoxide and hundreds of toxic by-products absent from e-cigarette aerosol.
Nevertheless, experts are quick to clarify that less harmful is not the same as harmless. The long-term health effects of inhaling heated chemicals over decades remain unknown, and nicotine itself is a highly addictive substance.
What Actually Helps People Quit Vaping?
Research into quitting vaping is still evolving, but early evidence points to effective strategies. A recent Cochrane Review co-authored by Professor Jamie Hartmann-Boyce found promising signs that text-message support programmes can aid quitting, particularly among teenagers and young adults.
There is also tentative evidence that the prescription medication varenicline, commonly used to quit smoking, could improve quit rates for adult vapers. Behavioural approaches are equally critical. Dr. Jaimee Heffner of the Fred Hutch Cancer Center is trialling Acceptance and Commitment Therapy (ACT), which teaches people to tolerate cravings without acting on them, with encouraging early results.
For those attempting to quit, experts offer a pragmatic roadmap:
- Identify and manage triggers: Notice the situations, emotions, or routines that prompt vaping and seek alternatives.
- Gradual reduction: Unlike with smoking, a slow taper of nicotine use is often recommended for vapers.
- Break autopilot habits: Set strict rules, like not vaping at your desk or only using it outdoors.
- Seek professional support: Using stop-smoking services or nicotine replacement therapy (like patches or gum) can double or triple the chances of success.
The advice is unanimous on one critical point: returning to smoking is not the answer. "Smoking is ridiculously deadly; one in two people who regularly smoke will die from it," emphasised Professor Hartmann-Boyce.
A Different Challenge for Young People
The public health equation changes for younger users. For most, vaping is not a route away from cigarettes but an initial introduction to nicotine. Dr. Rachel Isba, a paediatrician who piloted the UK's first NHS vaping cessation clinic for teenagers at Liverpool's Alder Hey Children's Hospital, is clear: "There is growing consensus that vaping in young people is a bad idea – children should only be breathing air."
Her clinic's approach focused on understanding the social and emotional reasons behind youth vaping, such as peer pressure or anxiety, rather than simply demanding abstinence. This model may inform future services across the NHS.
As the UK navigates this new era where vapers outnumber smokers, the message from health authorities is nuanced. While vaping presents a substantially reduced risk for adult smokers switching from cigarettes, its addictive nature poses a fresh challenge for a nation striving to become smoke-free.
