12/07/2016 12:01 BST | Updated 13/07/2017 06:12 BST

E-cigarettes: Maximising Benefit, Minimising Harm

Smoking remains the number one killer in England but people continue to quit and e-cigarettes are now the most popular quitting tool.

Clearly e-cigarettes have the potential to help many more people to quit smoking, and we need to embrace that, while minimising any potential harms.

One concern that has been raised about e-cigarettes is that they will attract young people and non-smokers and act as a route into smoking.

But despite high levels of experimentation, the current evidence shows that regular e-cigarette use among young people in the UK is almost exclusively seen in people who have previously smoked tobacco, and that the number of young smokers is actually continuing to fall.

The latest estimates show that 2.8 million adults in Great Britain currently use e-cigarettes, up from only 700,000 in 2012. Vapers are now fairly evenly divided between smokers (1.4 million) and ex-smokers (1.3 million). The main reasons given for e-cigarette use are to support cutting down or quitting tobacco use and to help avoid relapse to smoking.

We often hear people say "do e-cigarettes contain chemicals, are they safe?" and it's important to address this. Harmful chemicals found in tobacco smoke, including carcinogens, are either completely absent in e-cigarette vapour or if they are present, are mostly at levels 0.1% to 1% of that found in tobacco smoke with a few exceptions.

So it's worrying to hear that only 15% of the public accurately believe that e-cigarettes are a lot less harmful than smoking. Smokers who hold this belief are less likely to try an e-cigarette and much less likely to switch completely from smoking.

It is our duty to provide clear information; to reassure the 1.3 million e-cigarette users who have completely stopped smoking, and to encourage those who have not to try quitting with an e-cigarette.

New regulations

While the evidence is clear that e-cigarettes are significantly less harmful than smoking tobacco, new regulations in the UK bring further protection for both vapers and non-smokers.

In October 2015 it became illegal for retailers to sell e-cigarette products to anyone under the age of 18 or for adults to buy them on behalf of under-18s.

And in May 2016, the Tobacco and Related Products Regulations introduced higher standards of quality and safety for e-cigarettes and tighter restrictions on advertising and promotion.

Regulation of e-cigarettes has increased to make sure they are safe and that people have the information they need to make informed choices. Manufacturers of e-cigarettes have to conform to new safety standards, including specifying the ingredients used in their product and limiting the size of tanks and refills.

Consensus on e-cigarettes continues to build

E-cigarettes continue to spark debate among academics, health professionals and the public, but there is a growing consensus among key public health organisations on the role they can play in reducing smoking rates.

In August 2015, Public Health England's expert independent evidence review concluded that e-cigarettes, while not completely harmless, carry a fraction of the risk of cigarettes and have the potential to help smokers quit smoking which will improve the public's health.

In April 2016, The Royal College of Physicians published a report which reached similar conclusions.

Next steps

E-cigarettes are now England's most popular quitting method whilst local stop smoking services are the most effective method.

In 2014-15, two thirds of smokers who combined the two succeeded in quitting. We need to encourage local stop smoking services to support smokers who want to use e-cigarettes to quit smoking, while encouraging smokers to reach out to their local service for support.

We believe e-cigarettes have an important role within our work to reduce the ill health and early death caused by smoking, with real opportunities to improve the health of the most vulnerable and marginalised people in our society, especially in the short term.

But uncertainties about their long term health impact remain so we will continue to monitor the emerging evidence on e-cigarettes and their health impact and ensure everyone is kept informed.