Free vapes for smokers in A&E could help thousands to quit

A trial run by the University of East Anglia has found that offering free starter vape kits and referrals to stop smoking services to smokers visiting emergency departments could help thousands more smokers to quit each year.

Those offered a vape were 76% more likely to quit smoking
The trial, which took place between January and August 2022, involved six UK emergency departments, and compared the likelihood of smokers quitting when offered an e-cigarette and a direct referral for help, compared to printed advice on quitting smoking.

All of the participants had attended A&E to receive care for existing conditions or injuries, but were offered the opportunity to take part if they were currently a smoker. 484 of the patients were provided with advice from a stop smoking adviser, a starter vape kit, and a referral to their local stop smoking services, while the other 488 patients were given written information about quitting and how to access support, without actually being directly referred.

The study found that those who received a free vape kit and were referred to stop smoking services were 76% more likely to have given up smoking after six months, than those who were not provided with a smoking cessation tool or a referral for help.

This research suggests that providing support in places like emergency departments can help reach groups within the population who may not be actively seeking out stop smoking support of their own volition, but are willing and capable of engaging when given the opportunity. In fact, the study suggests that such intervention could lead to thousands more people successfully quitting smoking each year.

Dr Ian Pope, lead author of the study, revealed:

"Swapping to e-cigarettes could save thousands of lives. We believe that if this intervention was widely implemented it could result in more than 22,000 extra people quitting smoking each year.

"Attending the emergency department offers a valuable opportunity for people to be supported to quit smoking, which will improve their chances of recovery from whatever has brought them to hospital, and also prevent future illness."

Helping smokers choose a less harmful alternative
Not only does this study suggest that actively helping people to access their local stop smoking services is effective, but also that offering them a less harmful alternative to smoking can help to kickstart their stop smoking journey. Smoking remains the biggest cause of preventable death in the UK, Professor Caitlin Notley, co-lead of the trial, explains:

"About half of all people who smoke will die prematurely, losing on average 10 years of life, and for every death caused by smoking, approximately 30 more people are suffering from a smoking-related disease."

There are currently an estimated 6.4 million adult smokers in the UK, and the NHS suggests that around 76,000 people die every year from smoking related illnesses in the UK alone. But knowing the health implications of continuing to smoke does not necessarily make it any easier to kick the habit. That is why e-cigarettes are such a crucial tool for smoking cessation, as they not only replace the physical act of smoking and help users manage their nicotine cravings, but they are also a far less harmful option than smoking.

The Office for Health Improvement and Disparities reiterated in their Nicotine vaping in England: 2022 evidence update that vaping is at least 95% less harmful than smoking, and research has shown that using an e-cigarette is twice as effective for long-term smoking cessation than nicotine replacement therapies like patches and nicotine gum.

Hazel Cheeseman, Deputy Chief Executive of Action on Smoking and Health (ASH), urged that the findings should be "carefully considered by those in the NHS and local government who are planning services for smokers", adding:

"This type of low-cost offer of support combined with an e-cigarette and located where smokers are accessing existing care is exactly what we need to make rapid progress in our efforts to reduce smoking, particularly for disadvantaged groups."

The Government swap to stop scheme
This is not the only example of e-cigarettes playing an important role in widespread stop smoking initiatives. The Government showed their support for vaping around this time last year with the announcement of their swap to stop scheme, which is currently underway and providing 1 million smokers with a free vaping starter kit.

This scheme is something we are proud to be involved in, as we are providing starter vape kits to local authorities across the country which are used by clients, along with support from their local stop smoking services, to help them make the switch to a safer nicotine source.

Not only do initiatives like this help to support smokers in their quit attempt, but they also help demonstrate to the public that e-cigarettes are endorsed and trusted by the Government and NHS as an effective stop smoking aid. While there are still many smokers who falsely believe that vaping is as harmful as smoking, the reassurance of such trusted institutions can go a long way to shaping the public perception of vaping products and their safety relative to smoking.

However, it is important that this message does not get lost among the proposed new legislations and regulations that the Government intend to impose on vaping products.

Are the proposed vaping regulations a step too far?
While on one hand the Government are endorsing vaping as a tool for adult smokers, on the other they are actively working to bring in many new regulations and restrictions on vaping products that could actually be damaging to these efforts.

As a result of a rise in underage vaping, the Government issued a call for evidence and open consultation looking for opportunities to reduce youth access to vaping products and reduce their appeal to minors.

In January 2024 the Government announced their intention to ban disposable vapes by October 2025, as the rise in popularity of disposable vapes has played a significant part in youth uptake. While it is understandable that removing appealing and accessible products could be considered the most effective way to tackle youth vaping, there are fears that this knee-jerk reaction does not fully take into account the use of disposable vapes among adults.

As a simple to use and easily accessible vaping product, not only available in specialist vape stores but also in convenience stores, supermarkets, and many other locations, disposables are often one of the first products tried by smokers as a way to see how vaping could work for them. Although they will mostly move on to a reusable vape kit after an average of 11 weeks using disposables, the point remains that their complete removal could be detrimental to smoking rates, where better enforcement of the current laws on vaping and cracking down on the illicit vape market could be effective without adult smokers and vapers paying the consequences.

The Government also announced plans for a Vaping Product Duty as part of the Spring Budget 2024, which will add a tax duty to the price of e-liquids. While this duty could help to raise funds for enforcement authorities and stop smoking services, and will be accompanied by an increase in tobacco duty, it could also see the price of some vaping products over double. Not to mention that this will also make schemes like the swap to stop initiative more expensive to fund.

In their bid to tackle underage vaping the Government recently introduced the Tobacco and Vapes Bill to Parliament, which seeks new powers to regulate vaping products, including a possible flavour restriction, along with regulating how vapes are packaged and how they can be displayed in shops.

While some of these regulations are welcomed by the industry, others seem like an over-reach that could have significant consequences for adult smokers and vapers. For example, vape flavours have been proved to play an important role in making vaping an appealing and effective alternative to smoking. By restricting flavours there is a risk that many current vapers may in fact revert back to smoking if they can no longer access their preferred flavours.

The mixed messages of encouraging smokers to switch to vaping, while also working to make vaping products less affordable, less accessible, and less appealing to adults could have unintended consequences for smoking rates in the UK. Fortunately, these regulations are still in their infancy and there is still time for amendments to be made and for a balance to be struck between the need to protect children and the need to ensure adult smokers and vapers have access to products that can help them remain smokefree.