Number of smokers who think vaping is as or more harmful as smoking increases

The perception of harm around vaping is taking a turn for the worse, as four in ten smokers (39%) in Britain incorrectly believe vaping is as or more harmful than smoking, according to the latest ASH annual survey.

The figure is up from a third last year and one in five in 2019, and the public health charity has warned that the trend could undermine the government’s ‘swap to stop’ campaign offering 1 million smokers vapes to help them quit.

As per the survey, 1.8 million smokers (27%) have never tried vaping even though it’s a very effective quitting aid and 2.9 million smokers have tried vaping but stopped.

Among these 1.8 million smokers who are yet to try vaping 43 per cent believe e-cigarettes are as harmful or more than smoking up from 27 per cent in 2019.  Among the 2.9 million smokers who have tried vaping but stopped, 44 per cent believe vaping is as harmful or more than smoking up from 25 per cent in 2019.

The most accurate risk perceptions are among the 2.7 million ex-smokers who vape and 2.9 million ex-smokers who are ex-vapers, 75 per cent and 45 per cent of whom correctly believe that vaping is less harmful than smoking.

“The government has backed a vaping strategy as its path to reduce rates of smoking, but this approach will be undermined if smokers don’t try vapes due to safety fears or stop vaping too soon and revert to smoking,” Hazel Cheeseman, deputy chief executive of Action on Smoking and Health (ASH) said.

“The government must act quickly to improve public understanding that vaping poses a fraction of the risk of smoking.”

Dr Ruth Sharrock, Clinical Lead for Tobacco Dependency, North East and North Cumbria NHS Integrated Care Board added that vaping was an important tool to support smokers to quit.

“When I see patients who smoke they are already sick with smoking-related disease and have often given up hope of ever stopping. Vaping is a valuable tool in our armoury to tackle smoking, particularly for patients who are heavily addicted. However, too many of my patients have seen alarmist media headlines that worry them and put them off giving vaping a go.”

Alongside the 2023 data on adult vaping ASH has alsoc published a ‘myth buster’ challenging common misrepresentations of the evidence on vaping. This has been developed with the country’s leading experts on smoking and vaping and provides evidence that:

• Vaping is NOT more harmful than smoking
• Vaping is NOT more addictive than smoking
• Vaping is NOT a proven gateway into smoking
• Nicotine DOES NOT damage young people’s brain development

“Anxiety over youth vaping is obscuring the fact that switching from smoking to vaping will be much better for an individual’s health,” Professor Ann McNeill, King’s College London, author of the government commissioned review on the harms from vaping and contributor to the ASH myth buster, commented.

“It is wrong to say we have no idea what the future risks from vaping will be. On the contrary levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke, which indicates that any risks to health are likely to be a fraction of those posed by smoking.

“We must not be complacent about youth vaping and further regulation is needed, but so too is work to ensure many more adults stop smoking and vaping is an effective means of doing that’.”

Cheeseman added: “It’s not because they think it’s safe that teenagers are experimenting with vaping. Harm perceptions are even more inaccurate among teens than the adult population. They are vaping because products appeal to them and are cheap and easily accessible. Further regulation will be more effective than scare mongering. Worse, if teenagers who experiment with vaping think that smoking is just as bad, then there is a risk they may be more likely to smoke.”

Key findings of the survey:

Use of e-cigarettes

The proportion of the population using e-cigarettes this year is 9.1%, the highest rate ever, equal to 4.7 million adults in Great Britain.

2.7 million (56%) are ex-smokers

1.7 million (37%) are current smokers

320,000 are never smokers (6.7% of vapers, but only 1.1% of never smokers)

 Why people vape

The main reasons given by ex-smokers for vaping is to help them quit (31%); to prevent relapse (22%); because they enjoy the experience (14%); and to save money (12%).

The main reasons given by current smokers for vaping is to cut down on smoking (19%), to try to help them quit (17%) and to prevent relapse (13%).

The main reasons never-smokers vape is because they enjoy the experience (39%) and just to give it a try (27%)

Devices and products used

The most commonly used type of e-cigarette device remains a refillable tank system, with 50% of current vapers reporting this type as their main device.

However, disposable vapes have become more popular in 2023 (31%), compared with 2022 (15%) and 2021 (2.3%).

E-cigarettes with replaceable cartridges were used by 17% of vapers.

Use of disposable vapes has risen particularly quickly among younger adults. Among 18-24 year olds, over half of current e-cigarettes users (57%) use disposables as their main type in 2023.

The majority of adults currently vaping use nicotine strengths below 13 mg/ml. Only 1.2% of current vapers use e-liquids over the legal limit of 20 mg/ml with 13% saying they don’t know.

Perceptions of harm

Four in ten smokers incorrectly believe vaping is as or more harmful than smoking up from a third last year and one in five in 2019.

A third of smokers understand that vaping is less harmful than smoking, but fewer than one in ten that they are a lot less harmful than vaping.

Ex-smokers who vape (2.9 million) have the most accurate perceptions of harm, with 75% correctly identifying that vaping is less harmful than smoking.

Reasons why smokers haven’t tried using e-cigarettes

1.8 million (27%) of smokers have not yet tried e-cigarettes giving as their main reasons:

• Addiction (20% said they do not want to substitute one addiction for another, while conversely 9.0% said that they are not addicted to smoking and don’t need help to quit).
• Another 14% cited safety concerns; 13% that they do not believe that e-cigarettes could help them quit or cut down; and 8.4% not knowing enough about e-cigarettes.