Key take-home messages:
The disposable vape ban is intended to curb youth vaping, addressing the increasing use of vaping among youth in 2022 and 2023.
There is a concern that the ban may have unintended and disastrous consequences on people who have successfully quit, or who are transitioning to quit smoking by using disposable vapes. A potential relapse to smoking would be a public health tragedy.
Research suggests that vaping is approximately 25 times less harmful than smoking, and it has been effective in helping smokers quit.
The blanket ban on disposable vapes may remove an easy-to-use product for adult smokers, particularly those with physical or mental health challenges. This could worsen health inequalities and increase the risk of relapse.
There is risk of an illicit market for unregulated vaping products.
Drug Science is concerned by the Governments ban on disposable vapes and the potential unintended and disastrous consequences. The UK government has failed to strike a balance by reducing the harms of vapes for young people, whilst allowing market access to smokers that want to quit or are using vapes instead of smoking. It would be a public health tragedy if people that have quit smoking and moved to vaping revert to smoking due restrictions on disposable vapes. We must ask how will this ban be implemented and what will the implications be?
Cigarette smoking is the largest preventable cause of premature death worldwide. The harms associated with tobacco are undeniable and score highly in comparison to other drugs. There are still 1.2 million cigarette smokers and a further 744,000 who previously smoked and may be at risk of relapse. We must do all we can to promote harm reduction solutions of tobacco.
What do the statistics say on youth vaping and why the disposable ban?
Fig 1
Fig 2
According the annual youth survey by Action on Smoking and Health (ASH), there was a stark increase in regular and occasional use vaping by youth in 2022 which continued in 2023 (Figure 1-2). The statistics are concerning, and Drug Science welcomes the Government measures to introduce plain packaging and change how vapes are displayed in shops so they don’t appeal to children. However, it is unknown whether there will be an increase in smoking cigarettes by young people with the banning of disposable vapes, which would be a disastrous consequence.
What are the harms of smoking vs vaping?
The primary health risks associated with smoking stem predominantly from combustion, as highlighted in a multi-criteria decision making analysis (MCDA) conducted led by Drug Science (Nutt et al., 2014). This examined the comparative harms of different forms of nicotine delivery system, which suggested that vaping is approximately 25 times less harmful than smoking. An Australian expert group comparing twenty drugs which included cigarettes and vaping came to the conclusion that vaping was less than a tenth as harmful (Bonomo et al., 2019). These over-arching analyses are supported by growing data on the health benefits of switching from cigarettes to vaping reported from several expert centres across the globe. The UK e-cigarette trial led by Peter Hajek demonstrated that vaping is the best method for helping people to quit smoking.
Unintended harmful consequences of banning disposable vapes
The blanket ban on disposable vapes to curb youth vaping may inadvertently remove a popular, effective, and accessible product for adult smokers. Recent research suggests that a ban on disposable vapes would currently affect approximately 2.6 million adults in the UK and would particularly impact 316,000 adults under the age of 25 who have never regularly smoked and are more likely to use disposable vapes than refillable e-cigarettes (Jackson et al., 2024). The research indicates that around 750,000 smokers successfully quit using disposables between January 2021 and August 2023 (Jackson et al., 2024). In the US, vape bans have been linked to increased cigarette sales (Xu et al., 2022). Many smokers find non-disposable vapes technically challenging, especially those with physical (dexterity issues, poor eyesight) or mental health issues (Wadsworth et al., 2016; Ward et al., 2018). Vulnerable groups, such as smokers experiencing homelessness, face difficulties with breakages and refilling (Cox et al. 2020). Further research in the UK has shown that use of disposable vapes has risen in other vulnerable groups such as people from less advantaged social grades and those with a history of mental health conditions (Jackson et al., 2024). Removing an easy-to-use product could worsen existing health inequalities by discouraging vaping in smokers and increasing relapse risks. These groups will require extra support to encourage the use of non-disposable e-cigarettes or other safter nicotine alternatives to help them avoid relapse. The Government must detail what will be done to support these groups.
In the past few years, Australia, Brazil, and Japan have either banned vaping products or limited certain aspects of the e-cigarette marketplace. Most recently, in September 2019, India banned the sale of e-cigarettes outright. Complete prohibition of vaping can extrapolate existing harms from cigarettes and could result in users turning to the illicit market for a wider variety of products. Young people can already access illegal vapes and a blanket prohibition could exacerbate the prevalence of illegal disposable vapes, which is already substantial and growing. These would evade regulatory oversight and lack standards on their contents.
In the ongoing effort to address the complex harm reduction landscape of smoking and vaping, it will be critical to monitor and analyse smoking/vaping statistics spanning all age groups in the coming years. While acknowledging the need to curb youth vaping, a nuanced approach is essential to safeguard the gains made in harm reduction among adult smokers. It is crucial to convey a clear public health message, encouraging cigarette smokers or non-disposable vapers to transition to non-disposable e-cigarettes and vapes, emphasising the health benefits of safer options. We need plans tailored to support vulnerable groups currently relying on disposable vapes to provide necessary assistance and resources to facilitate a smooth transition to e-cigarettes or non-disposable vapes. Drug Science firmly believes harm reduction must always remain a priority.
References
ASH. (2023). Use of e-cigarettes among young people in Great Britain, This fact sheet examines evolving youth use of e-cigarettes in Great Britain in the context of changes in the regulation of e-cigarettes, and use of tobacco among adults and children. Available at: https://ash.org.uk/resources/view/use-of-e-cigarettes-among-young-people-in-great-britain (Accessed: 6 February 2024).
Bonomo Y, Norman A, Biondo S, Bruno R, Daglish M, Dawe S, Egerton-Warburton D, Karro J, Kim C, Lenton S, Lubman DI, Pastor A, Rundle J, Ryan J, Gordon P, Sharry P, Nutt D, Castle D. (2019). The Australian drug harms ranking study. Journal of Psychopharmacology, 33(7): 759–768.
Cox, S., Leigh, N. J., Vanderbush, T. S., Choo, E., Goniewicz, M. L., & Dawkins, L. (2019). An exploration into “do-it-yourself”(DIY) e-liquid mixing: Users’ motivations, practices and product laboratory analysis. Addictive behaviors reports, 9, 100151.
Nutt, D. J., Phillips, L. D., Balfour, D., Curran, H. V., Dockrell, M., Foulds, J., … & Sweanor, D. (2014). Estimating the harms of nicotine-containing products using the MCDA approach. European addiction research, 20(5), 218-225. https://doi.org/10.1159/000360220
Jackson SE, Tattan-Birch H, Shahab L, Oldham M, Kale D, Brose L, Brown J. (2024). Who would be affected by a ban on disposable vapes? A population study in Great Britain. Public Health, pp. S0033-3506(23)00503–6. Available at: https://doi.org/10.1016/j.puhe.2023.12.024.
Wadsworth, E., Neale, J., McNeill, A., & Hitchman, S. C. (2016). How and why do smokers start using e-cigarettes? Qualitative study of vapers in London, UK. International journal of environmental research and public health, 13(7), 661.
Ward, E., Cox, S., Dawkins, L., Jakes, S., Holland, R., & Notley, C. (2018). A qualitative exploration of the role of vape shop environments in supporting smoking abstinence. International Journal of Environmental Research and Public Health, 15(2), 297.