E-cigarettes: an evidence update. A report commissioned by Public Health England.

TLDR: There is no evidence that EC are undermining the long-term decline in cigarette smoking among adults and youth, and may in fact be contributing to it, and new regulations currently planned should also maximise the public health opportunities of EC.

Abstract: E-cigarettes are 95% less harmful to your health than normal cigarettes. When supported by a smoking cessation service, they help most smokers to quit tobacco altogether. Key messages: 1. Smokers who have tried other methods of quitting without success could be encouraged to try e-cigarettes (EC) to stop smoking and stop smoking services should support smokers using EC to quit by offering them behavioural support. 2. Encouraging smokers who cannot or do not want to stop smoking to switch to EC could help reduce smoking related disease, death and health inequalities. 3. There is no evidence that EC are undermining the long-term decline in cigarette smoking among adults and youth, and may in fact be contributing to it. Despite some experimentation with EC among never smokers, EC are attracting very few people who have never smoked into regular EC use. 4. Recent studies support the Cochrane Review findings that EC can help people to quit smoking and reduce their cigarette consumption. There is also evidence that EC can encourage quitting or cigarette consumption reduction even among those not intending to quit or rejecting other support. More research is needed in this area. 5. When used as intended, EC pose no risk of nicotine poisoning to users, but e-liquids should be in ‘childproof' packaging. The accuracy of nicotine content labelling currently raises no major concerns. 6. There has been an overall shift towards the inaccurate perception of EC being as harmful as cigarettes over the last year in contrast to the current expert estimate that using EC is around 95% safer than smoking. 7. Whilst protecting non-smoking children and ensuring the products on the market are as safe and effective as possible are clearly important goals, new regulations currently planned should also maximise the public health opportunities of EC. 8. Continued vigilance and research in this area are needed.