Despite the impressive drop in local smoking rates achieved by endorsing the use of vaping products as cessation aids, the British Medical Association (BMA) is urging the UK government to address what it describes as a “growing epidemic” of vaping. Echoing concerns worldwide, the BMA is especially concerned about vaping rates among minors which have surged nearly six-fold in the past decade.

In its report, “Taking our breath away: why we need stronger regulation of vapes,” the BMA proposes several measures to curb this trend. These include banning the sale of disposable vapes, prohibiting all non-tobacco vape flavours, and enforcing restrictions on vape packaging and branding, similar to those for cigarettes. The BMA also calls for stricter advertising rules, keeping vapes behind the counter in shops, as well as public education campaigns to highlight the dangers of vaping.

The BMA acknowledged that vapes can help some adults quit smoking, however it added that vaping is not risk-free and can lead to nicotine addiction and other health problems. The association also highlighted concerns about the environmental impact of the devices, with two vapes being discarded every second in the UK. The report calls on the government to adopt bold measures, as proposed in their report, to prevent vaping from becoming normalized among children and adolescents.

The BMA’s recommendations would benefit the black market

Studies have indicated that the overall effect of teen vaping has been to reduce smoking rates among this demographic.
John Dunne, Director General of the UK Vaping Industry Association (UKVIA), responded to the BMA report agreeing that stricter measures are needed to prevent youth vaping and the sale of illicit products. However, argued Dunne, the BMA’s proposed actions would boost the black market, hinder the UK’s smoke-free goals, and discourage adult smokers from switching to vaping.

Dunne criticized the BMA for downplaying the effectiveness of vapes in helping people quit smoking, citing data from Action on Smoking and Health (ASH) that showed more than half of recent ex-smokers in Great Britain used vapes to quit. He also noted that youth vaping has decreased since last year.

Moreover, studies have indicated that the overall effect of teen vaping has been to reduce smoking rates among this demographic. This suggests that vaping is displacing smoking:  which in itself should be considered a significant stride forward for public health.

In line with the opinions of fellow peers, Dunne opposed the BMA’s call for a ban on non-tobacco vape flavours, highlighting that they are crucial for the success of vaping as a smoking cessation tool. He referred to the Royal College of Physicians’ support for flavoured vapes.

Smoking cessation attempts are more successful with flavoured vapes

Moreover, research by UKVIA, including Freedom of Information requests to 45 local authorities and NHS trusts across England, revealed that over 95% of stop smoking services offer vapes as a tool for smoking cessation. Among these services, 100% provide flavoured vaping products such as fruit, mint/menthol, tobacco, and dessert flavours, but nearly 70% reported that fruit flavours were among the most popular choices for smokers. The study also found that quit attempts using vapes were generally more successful than those without. Many services also use the government’s swap-to-stop scheme, which provides flavoured vapes to help smokers quit.

The UKVIA called for action to prevent youth-targeted products from reaching the market. In line with another report released earlier this month, he suggested the introduction of a licensing scheme to regulate vape sales, particularly to keep them out of inappropriate outlets like sweet shops. Dunne also emphasized the need for increased penalties for illegal sales and funding for Trading Standards enforcement. He concluded by urging the BMA to support public education campaigns highlighting the benefits of vaping for adult smokers as a less harmful alternative to traditional cigarettes. Amongst other things, this would save the NHS significant healthcare costs associated with smoking-related illnesses.

Smoking cessation experts: leave flavours alone!

Experts in the field of smoking cessation agree with Dunne, with several expressing concerns about the recommendations put forward the BMA. Prof. Peter Hajek from Queen Mary University of London argued that while some proposed regulations are sensible, banning all non-tobacco vape flavours is misguided. He emphasized that reducing smoking should be the primary goal, and non-tobacco flavours are preferred by both adult and youth smokers attempting to quit. He highlighted that smoking rates among youth are at an all-time low thanks to the popularity of vapes, and stressed the need for a balanced approach that does not overlook the benefits of vaping in smoking cessation.

Similarly, Prof. Lion Shahab from University College London agreed on the necessity to restrict youth access to vapes, suggesting measures like standardized packaging, marketing restrictions, and display bans. However, he cautioned against flavour bans, as they are crucial for adult smokers transitioning from cigarettes. Shahab warned that banning flavours could inadvertently increase smoking rates and propagate the misconception that vapes are as harmful as cigarettes. He advocated for a balanced approach that reduces youth vaping appeal without undermining vaping as a harm reduction tool for smokers. He suggested limiting flavours without eliminating them, ensuring products are marketed responsibly, and maintaining public health messaging that vapes are primarily for smoking cessation.

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