World Leading Brits

Consumers and businesses, politicians and health organisations have ways of doing things. Over time, preferences are formed and best practices honed. Then, once in a while, something new is created. Something new and instantly recognisable as being far superior to that which went before – a disruptive technology sweeping away old habits and procedures. A disruptive technology like vaping. How Britain adapted when faced with an electronic substitute to tobacco will form book chapters in years to come.

Slow off the mark
Great Britain wasn’t ready for vapes, but then no country was, and they slowly gained a cult following among ex-smokers who couldn’t believe how easy they found switching, the ‘new’ electronic alternative to smoking went under the radar.
By 2014, millions of smokers had tried vaping and over two million were now regular vapers having heard about it by word of mouth. Friends were showing their basic devices to each other, people who’d successfully concocted a tasty eliquid at home were sharing their recipe with other enthusiasts online. The snowball had become an avalanche.

To the health establishment it looked like smoking and, despite this being one of the reasons why it was working, they assumed it would be as bad as smoking. Several anti-smoking campaigners publicly stated how they knew nothing about the technology or its health implications but warned about possible dangers all the same.

One single quit smoking service had embraced vapes as a possible root out from tobacco addiction and was trying to change attitudes within the NHS. The National Centre for Smoking Cessation and Training published its first guide talking about how early indications were that vapes would be a low-risk product and limited trials demonstrated vapes could be more successful than traditional nicotine replacement products.

Changing direction
By 2017, the situation was mixed with some Trusts promoting vaping to smokers and others like Hull occupying a strange position of telling smokers to switch but banning them from using vapes on hospital grounds, equating vaping to smoking. By the end of 2017, Hull recognised the evidence put forward by Public Health England and allowed patients and visitors to vape on the grounds – but not staff.
A confused approach but still one that was miles in front of any other country.
The NHS finally published a page on its site stating: “Evidence indicates that e-cigarettes can help people quit smoking, with similar or better results than nicotine replacement therapies such as patches or gum”.

The seeds of success are noted
Tobacco harm reduction advocates look at us enviously as the ensuing years have seen some hospitals install vape vending machines. Others, such as in Birmingham, opened up vape stores near to their Accident and Emergency departments. While other countries were pushing through bans on vaping and the sale of vape products, we were steaming ahead with proactive, evidence-based measures to reduce the number of smokers and tobacco-related diseases and deaths. Oddly, the anti-smoking campaigners from 2014 who were opposed to vaping clung on to their views despite the overwhelming body of research evidence proving them wrong.
Across 2021 and 2022, trials were conducted in selected A&E Departments to see if delivering quit smoking advice and the opportunity to have a free vape starter kit would help the NHS target hardened smokers. The results were overwhelmingly positive.
Gillian Golden, the Chief Executive of the Independent British Vape Trade Association said at the time: “This trial, and the involvement of the NIHR and the NHS, is a huge affirmation that our members’ tireless work over many years has been and is worthwhile.”

The modern day
Looking back at Hull again, we can see how far change has come. Over the last couple of months, the NHS Targeted Lung Health Checks programme has targeted patients in Humber and North Yorkshire for free screenings. At the same time, the Swap and Stop tobacco programme has been offering recyclable single-use vapes to all smokers at the entrance to Hull Royal Infirmary. This time, workers at the hospital have been included too.
Programme manager Dave Jones spoke about the project, showing how far that one Trust has moved: “There is a lot of confusion about vaping, but when it is used as a tool to stop smoking tobacco, it is highly effective and has great success rates. The NHS fully supports people who choose to use them.”

Even the government gets praised
At a point in time when the current government can’t seem to buy approval, international public health advocates routinely sing its praises when it comes to vapes and tobacco harm reduction.
Following on from the evidence-based policy making during the Aids crisis, the government commissioned a series of evidence updates looking at vapes in order to justify legislative decisions. Despite there being room for some improvements, most would accept that the approach has been good so far.
The recent Autumn Statement gave overseas onlookers another opportunity to highlight our positive position. The government announced tobacco duty hikes, raising rates by 2% over inflation and 12% for hand-rolling tobacco.

While other countries are targeting vapes and eLiquids for additional taxation, the Chancellor recognised how this would be detrimental to encouraging smokers to switch and did not change the rate.

Dr Delon Human praised the risk-proportional taxation system. Speaking on behalf of the Smoke Free Sweden movement, he said: “The UK’s decision is a commendable step towards a more nuanced and effective public health policy. In not increasing taxes on reduced-risk products, the UK government is acknowledging the importance of providing accessible alternatives for adult smokers to help them take the step of quitting. This approach is very much in line with the strategies in Sweden, which is on the brink of declaring itself officially smoke free.”
With new ministers at the Department of Health about to mull over the responses to a government consultation on teen vaping, it is hoped they bear in mind the success Britain, and especially England and Wales, has seen thanks to the world-leading support vaping has enjoyed to date.