GTNF 2016 C. Russell

How Public Health England Is
Driving a Migration from
Smoking to Vaping
Christopher Russell Ph.D.
Centre for Substance Use Research,
Glasgow, United Kingdom
russell@csures.org
Global Tobacco and Nicotine Forum
Brussels, Belgium
29 th September 2016

Disclosure
• My research centre is in receipt of funding from
e-cigarette manufacturers to conduct research on
tobacco harm reduction; specifically, how more
smokers can be persuaded to use an e-cigarette to
support an attempt to quit smoking.
• I advocated for adoption of tobacco harm
reduction products and policies long before we
ever received this funding, and will continue to
promote tobacco harm reduction regardless of the
commercial or other interests of any funding
organisation.

‘Pushing the Switch’
• Factors that rationalise smokers’ adoption and rejection
of e-cigarettes (i.e. what drives switching and staying?).
• Psychological
• Experiential, emotional
• Product
• Policy
• Communication from health organisation à Effects
potentiated by health org’s positions on the
appropriateness of e-cigarettes for the protection of
public health.

FDA
• Use precautionary principle against e-cigarettes.
• ‘Insufficient evidence at this time for
manufacturers and physicians to recommend e-
cigarettes as a safe and effective aid to smoking
cessation.’
• ‘Duty to protect citizens’ health by implicitly
and explicitly discouraging e-cigarette use.’

Public Health England
• Use precautionary principle for e-cigarettes.
• Sufficient evidence at this time to conclude e-
cigarettes pose substantially less risk to health
than smoking cigarettes, and can be an effective
aid to smoking cessation.
• Opportunity to improve smokers’ health by
explicitly encouraging and assisting e-cigarette
use.

What changes are PHE trying to effect?
1. Increased acceptability of e-cigarettes to smokers.
2. Reduced misperceptions of the absolute and
relative harmfulness of e-cigarettes; increasing
prevalence of evidence-based perceptions of
harmfulness.
3. Increased displacement of cigarette smoking by e-
cigarette use.
4. Increased ‘use as intended’, reduced adverse
events stemming from user error.
*FDA does not specify these changes as targets, let
alone priorities.

What does PHE need to do to effect
these changes?

What has PHE done to increase smokers’
capability, opportunity and motivation to
switch to e-cigarettes?

A joint statement that reflects the commitment of several major
UK health organisations to increasing smokers’ capabilities,
opportunities and motivation to switch, while committing to
monitoring for unintended consequences of this commitment.

A technical guidance document, produced in partnership with
PHE, that reflects a multi-org commitment to empowering
smoking cessation counsellors to increase smokers’ capabilities,
opportunities and motivation to switch to e-cigarettes.

The Potential of E-Cigarettes to
Reduce TRH
GOOD NEWS
• In 2015, 2.2 million people in Great Britain
using an e-cigarette…
• Of whom, approximately 836,000 (38%) had
switched completely away from smoking to
vaping (Office for National Statistics, 2016).

The Potential of E-Cigarettes to
Reduce TRH
GOOD NEWS
• UK NHS estimates value of a ‘successful quit’ at
£74,000 (US $96,500) based on an average of 1.2 life
years saved and £60,000 (US $78,250) per life year.
• The 836,000 people who had replaced smoking with
vaping by 2015 represent a saving to UK society of at
least £58.9 billion, assuming vaping carries up to 5%
of the risk associated with smoking.
• No PH intervention for smoking cessation can claim
such a reach – 2.2 million current e-cigarette users –
and such success – 836,000 former smokers – in such
a short space of time.

The Potential of E-Cigarettes to
Reduce TRH
BAD NEWS
• 36% (3.17 million) of the approximately 8.8
million smokers in Great Britain have never
tried using an e-cigarette.
• Additionally, seven in every ten GB smokers
who trial an e-cigarette – 41% (3.61 million) of
all smokers – do not go on to become a regular
e-cigarette user.

‘Pushing the Switch’
• Persuading more smokers to try an e-cigarette,
and then supporting them to persist with an e-
cigarette as an alternative to smoking, is vital to
the success of e-cigarettes in reducing tobaccorelated
harm.
Q. How can more smokers be persuaded to try using
an e-cigarette in place of regular cigarettes, and then
switch completely from smoking to vaping?

Thank You For Listening
Questions?
For slides…
Dr Christopher Russell
russell@csures.org