Royal College of Physicians

On April 28, 2016, the Royal College of Physicians published “Nicotine without smoke: Tobacco harm reduction”, a report which lauds e-cigarettes as playing a key role in helping British smokers to quit. The report represents the first such position formally articulated by a high-ranking medical body, and as such may help to shape policy for vaping and e-cigarettes not just in the United Kingdom, but in many countries which are struggling to make policy and laws to keep up with the ecigarette trend.

The report garnered attention in the international media for its active promotion of e-cigarettes as a means to quit smoking. It confirms what e-cigarette users have known for quite some time. E-cigs and vaping devices provide all of the experience of smoking - the vapour which simulates smoke, hand-to-mouth delivery, and flavour - without the harmful levels of chemicals and compounds contained in traditional cigarettes.

“E-cigarettes have the capacity to replace more of the characteristics of tobacco cigarettes than conventional Nicotine Replacement Therapy (NRT), and therefore have potential as effective smoking substitutes.” -p.64, Nicotine without smoke RCP Report


E-cigarettes safe, effective alternative to smoking according to Royal College

While the report did express some concern about chemicals and compounds contained in e-cigarette vapour, the conclusion was that they are far below the levels contained in traditional cigarettes and would cause no significant harm to vapers. From the report:

“In normal conditions of use, toxin levels in inhaled e-cigarette vapour are probably well below prescribed threshold limit values for occupational exposure, in which case significant long-term harm is unlikely.” - p. 79, Nicotine without smoke RCP Report

The report went on to examine the individual components of e-liquids, such as glycerine, flavour compounds, and propylene glycol and found that each was unlikely to have substantive negative effects on e-cigarette smokers or bystanders who would inhale secondhand smoke from e-cigarettes. The report suggested that improvements in standards on e-liquids could help to reduce any possible long-term effects.

Long-term risks of e-cigarettes 5% of that of traditional cigarette smoking 

The report states that as of now, the potential long-term risks associated with vaping are 5% of those associated with tobacco cigarettes, and with standards on and improvements in the eliquid manufacturing process may help to reduce even that risk.

E-cigarettes offer a “high quit rate” based on early data

When coupled with behavioural support, the report states that early data show that e-cigarette smokers have a high quit rate. Smokers who use nicotine products to cut down the amount they smoke are more likely to try to quit, and promotion of and making e-cigarettes more widely available would encourage more smokers to quit.

Kids not likely to use e-cigarettes as a gateway to smoking

The report showed that children under 18 who had tried e-cigarettes had mostly done so only once or twice and that e-cigarettes were much more likely to be used by people who were already traditional smokers. This puts to bed the fears that vaping opponents have had that children will use e-cigarettes and then be encouraged to take up smoking. The recommendations from the report were not just to allow e-cigarettes, but to actively promote them as a means to quit smoking:

“In the interests of public health it is important to promote the use of e-cigarettes, NRT and other non-tobacco nicotine products as widely as possible as a substitute for smoking in the UK.”-p. 190, p. 79, Nicotine without smoke RCP Report

You can read the recommendations from the report and download the full report from the Royal College of Physicians website.