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Evidence around vaping

There are now a number of detailed evidence reviews around the impact of vaping.

The latest report commissioned by the UK government via OHID is the eighth and final in the current series and was led by academics at King’s College London with a group of international collaborators.

It is the most comprehensive to date and the focus is a systematic review of the evidence on the health risks of nicotine vaping. It also includes recent vaping prevalence data for young people and adults, and looks at flavours, nicotine and people’s perceptions of vaping harm.

The conclusions were that:

  • in the short and medium term, vaping poses a small fraction of the risks of smoking
  • vaping is not risk-free, particularly for people who have never smoked
  • evidence is mostly limited to short- and medium-term effects and studies assessing longer term vaping (for more than 12 months) are necessary
  • more standardised and consistent methodologies in future studies would improve interpretation of the evidence

The Cochrane Review set out to establish if using e-cigarettes could help people to stop smoking, and if people using them for this purpose experience any unwanted effects. The Review concluded:

  • Nicotine e-cigarettes can help people to stop smoking for at least six months. Evidence shows they work better than nicotine replacement therapy, and probably better than e-cigarettes without nicotine.
  • They may work better than no support, or behavioural support alone, and they may not be associated with serious unwanted effects.
  • However, we still need more evidence, particularly about the effects of newer types of e-cigarettes that have better nicotine delivery than older types of e-cigarettes, as better nicotine delivery might help more people quit smoking.

The National Institute for Health and Care Excellence (NICE) has, for the first time, included vaping products as a recommended stop smoking aid in its newly released tobacco guidelines – Tobacco: preventing uptake, promoting quitting and treating dependence.

The guidelines mean that alongside providing clear and up-to-date information about vaping products, stop smoking services should also make these products accessible to adults who want to use them to quit.

Nicotine-containing e-cigarettes must be notified to the Medicines and Healthcare products Regulatory Agency (MHRA) and must meet the requirements of the European Union (2014) Tobacco Products Directive (definition informed by the MHRA’s e-cigarettes regulations for consumer products).

The National Centre for Smoking Cessation and Training (NCSCT) has produced professional guidance: Electronic cigarettes: a briefing for stop smoking services. This briefing recommends that stop smoking services should be open to e-cigarette use in people keen to try them to help them quit. This is especially so in those who have tried and failed to quit using licensed stop smoking medicines.


Useful links:

Nicotine vaping in England: 2022 evidence update main findings [OHID]

Nicotine vaping in England: 2022 evidence update summary [OHID]


Youth vaping: call for evidence – closes 6 June 2023 [OHID]

Use of nicotine vapes (vapes) among adults in Great Britain [ASH]

Use of nicotine vapes among young people in Great Britain [ASH]

Nicotine Vapes for Smoking Cessation: Cochrane Living Systematic Review [Centre for Evidence-Based Medicine]

Vaping: policy, regulation and guidance [OHID]


Vaping in England: 2022 evidence update summary [OHID]

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