Highlights from England

On this page, I set out some of the good things about tobacco harm reduction that have come from England.

Updated October 2022.

Also, see my book chapter (2019) on harm reduction developments in England since 2010. Tobacco harm reduction in England – England’s Tobacco Control Plan 

1. National government policy statements (England)

1.1. Pro-harm-reduction national policy statements…

Note: October 2022. A new government tobacco policy is still expected in 2022 to set out measures to meet the smoke-free goal to reduce smoking prevalence to less than 5% by 2030. The Khan review (see ‘Independent advice’ below) was supposed to feed in to this.

1.2 Independent advice

Khan Review: Making smoking obsolete (Summary) (August 2022) Full report (PDF) and press release. Note this is an advisory report to the government, not a statement of government policy. My critical review: Independent review of tobacco policy in England misses the point

1.3 With support in Parliament

2. Realistic science

2.1 Public Health England (and successors)

“Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know”

Public Health England, 2018

2.2 Committee on Toxicology

2.3 Royal College of Physicians

Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure“. (Section 5.5 page 87)

Royal College of Physicians, 2016

For a discussion of key quotes from this document, see my submission to the Government of Ireland: Vaping and tobacco harm reduction in Ireland – consultation response in five quotes– February 2017.

2.4 Other useful scientific perspectives

  • Dr. Lynne Dawkins, South Bank University – E-cigarettes: an evidence update – all on a guest blog. Myth busting lecture on the science of vaping (slides). November 2018.

2.5 Collaborative research approach

3. Practical professional guidance and public communications

3.1 On youth vaping

3.2 On quitting smoking for professionals…

3.3 Vaping and Pregnancy

3.4 Vaping and mental health

3.5 Public-facing communications

The national healthcare provider, the National Health Service endorses the use of e-cigarettes to stop smoking. Annual stop-smoking campaigns encourage users to quit or switch.

3.6 On smoke-free policy…

3.7 On e-cigarette advertising

These reflect the view that vaping policy should be a matter for the owner or manager of the premises, not subject to a blanket legal ban.

These very sensible industry codes govern the advertising that is not banned by the wholly disproportionate EU Tobacco Products DirectiveArticle 20(5) as it applies in the UK.

4. Reasonable public health consensus statements and positions

4.1 Cabinet Secretary (Head of UK civil service)

Blog by Sir Jeremy Heywood: How the Nudge unit threw light on lighting up 2015

4.2 Consensus statement

2016 statement by Public Health England, Action on Smoking and Health, Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Healthier Futures, Public Health Action (PHA), Royal College of Physicians, Royal Society for Public Health, UK Centre for Tobacco and Alcohol Studies, UK Health Forum

4.3 Individual organisations and people

Professor Ann McNeill, the lead author of 2018 Public Health England E-cigarette evidence review, discussing the review:


UK experts talking sense about vaping and harm reduction – on video (Ann McNeill, John Britton, Robert West, Deborah Arnott, Ian Gray) and see many of the same experts on The Switch (2017) below:

Professor Linda Bauld of Cancer Research UK and Dr Richard Roope of Royal College of General Practitioners and CRUK Cancer Clinical Champion, addressing key concerns that GPs have voiced about e-cigarettes.


4.4 UK Parliamentary inquiry – December 2017 – December 2018

The House of Commons Select Committee on Science and Technology inquiry into e-cigarettes took evidence in December 2017. See:

Some highlights from the submitted evidence.

My contribution and a better-formatted version here

5. High quality, timely and useful data

6. Engaged consumers

7. Groundbreaking conferences

8. Forthright commentators

9. Engaged trade associations

Please add suggestions for additions (with links please) in the comments…

6 thoughts on “Highlights from England”

  1. I have nothing to add except to say that a society that encourages reduced harm in such an honest and transparent way will surely benefit. And this atmosphere will surely deal best with any unforseen problems in the future.

  2. Wow, I bet there was a lot of work in putting all this together, I hope a lot of people get to read and use it.

  3. Brilliantly done overview as expected from you Clive. Highly useful for so many (even us foreigners) and not just as a reference. many thanks.

    You Brits have been the leading force on our globe on harm-reduction and alternative choices for people to quit smoking. As such you are influencing people in many countries in a positive way, especially wth your landmark reports from PHE & RCP.

    As often said without the leadership and guidance from you guys in UK we would sit up (or lie down) with defective and misinformed policies from powerhouses like WHO and the US Health (CDC & FDA). That would really be a shitty situation for us all.

    As I thank you Brits, as have often done before, for your fantastic contribution then at the same time would like to see more global perspective from UK. Know of course PHE, RCP, UKCTAS etc are British and never will be otherwise. But what affects UK will/does will in many similar ways also affect us all, and I think you are very well aware of that fact already.

    The globe is in great need for a broader perspective or a global one, which relates to everyone on this planet not just UK or the old commonwealth nations or just the English speaking ones. We really need an alternative instead of WHO as it acts now, though with high and beautyful ideals as the health leader, it’s policies (FCTC) today do not fullfill it’s promise.

  4. ITC England cohort survey (2016-2020) of current and recent former smokers and current vapers plus ITC adolescent surveys 2017, 2018, 2019, 2020, 2021

  5. An up-to-date encyclopaedia of the immense contribution from many sectors of the UK to the knowledge of tobacco harm reduction that the world can benefit from. Thank you Clive, for putting it all together

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