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Vapes aren’t enough to stop people smoking

The government should be funding cessation services and cracking down on Big Tobacco rather than fixating on e-cigarettes.

By Anthony Laverty

The government in England has made headlines with its plans to encourage adult cigarette smokers to switch to vaping, while simultaneously cracking down on underage vape sales. The plan has some merits, but this eye-catching suggestion obscures the fact that the overall strategy is limited in ambition and funding.

In 2019, the government committed to reducing smoking rates in England to 5 per cent by 2030. Since then, there has been a lack of concrete action to achieve this. Cancer Research UK estimates that the target will be missed by nine years, while the independent review by Javed Khan published last year was clear that it would take even longer in the poorest parts of England. The government’s latest plan has supposedly been informed by this review but omits many of its key proposals, including greater funding, a new levy on tobacco company profits, and raising the legal age for cigarette sales.

The evidence is clear that e-cigarettes can help people quit smoking tobacco and so there is potential for tangible positive impacts. However, the devil is likely in the detail; it remains unknown how this scheme will work in practice, or how far the estimated £45m allocated to it will go.

[See also: Now that I have cancer, how should I live?]

Tobacco smoking is addictive and designed to be so. Quitting is difficult for many people and measures such as personalised support in the form of smoking cessation services would enhance the chances of people quitting. Funding for these services in England has been cut by 45 per cent since 2015 and there is no mention of plans to allocate more money.

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However, the government’s announcement also included welcome plans to give pregnant women financial incentives of up to £400 per person to stop smoking tobacco – an effective policy that has been a long time coming, and is shown to reduce harms and be good value for money.

But the recommendations from the Khan review that have been omitted mean that overall, the strategy is not sufficient. According to the Khan review, a comprehensive tobacco control strategy would require at least £125m per year – much more money than the government is suggesting. This money could be used to ensure good provision of stop-smoking support and well as reinstating mass media campaigns. Compared with the estimated £21bn per year costs of tobacco smoking to British society, this would be money well spent.

Rather than coming from taxation, a “Polluter Pays Levy” capping the excessive profits of the tobacco industry could raise £700m per year, which could go directly to the Department of Health and Social Care. This levy would be simple to implement – it is based on existing schemes – and would underline the fact that the tobacco industry is unique in making huge profits from selling a product that kills when used as intended. There is cross-party political support for these measures, as well as public support, but the Treasury appears to be blocking it.

Khan also recommended raising the age of sale for tobacco by one year, every year until no one can buy a tobacco product in England. This would remove it from schools and the hands of children and is a proposal that has been supported by the All-Party Parliamentary Group on Smoking. Tobacco smoking remains the greatest risk to children’s health, not vaping. We know that raising the minimum legal age of sale from 16 to 18 years reduced smoking rates, but the government has declined to do so again, claiming to be “focused on helping people to quit”. This sounds laudable but neglects the fact that hundreds of children are taking up smoking every day and that the decline in smoking tobacco over recent decades has been mainly driven by reducing smoking uptake among young people. Children with parents or friends who smoke are more likely to start, meaning that these harmful habits are spread within communities.

The government’s latest plan to reduce smoking rates includes some welcome steps, particularly in helping pregnant women to quit. But while incentivising a switch to vaping may be striking, the more long-lasting and substantial measures laid out in the Khan review have not been taken up.

[See also: Would Wes Streeting’s smoking ban work for the UK?]

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