Amid the FDA and Big Tobacco anti-vaping efforts, the UK is giving away a million free vapes to its citizenry to help them stop smoking cigarettes. The stark contrast between the approaches of these two superpowers points to the huge disconnect between the countries that believe the science, and those that don’t. While Big Tobacco continues to fabricate stories around teen vaping, the FDA points to old information when teen vaping was a crisis. That has changed according to the CDC’s 2023 report, but the powers in charge keep beating the old drum and passing laws that no longer apply.

The U.K. government has set an ambitious target to make the country smoke-free by 2030, reducing smoking prevalence to 5% or less of the population. Proposed in July 2019, the government has been developing policies to achieve this goal.

The Khan review, published in June 2022, provides an independent evaluation of the government's policies, and suggests additional measures to accelerate progress toward the smoke-free 2030 target. Some of the key recommendations include the following:

• Offering vapes to 1 million smokers.
• Raising the age of sale for tobacco products from 18 to 21.
• Banning the sale of menthol cigarettes and flavored tobacco products.
• Introducing a levy on the tobacco industry to fund tobacco control initiatives.
• Provide better support for smokers to quit.

Proposed Role of Vapes for UK Tobacco Cessation

In the U.K., using nicotine vapes and ENDS (Electronic Nicotine Delivery Systems) as a tobacco cessation tool is generally seen as a positive development. They cite science from Public Health England which suggests vaping is 95% less harmful than traditional cigarettes. The Khan review notes that vaping can be a powerful tool in reducing smoking prevalence and recommends that smokers unable or unwilling to quit smoking should be encouraged to switch to ENDS. The review recommends including ENDS devices in the U.K.'s Stop Smoking Services. It also recommends training for healthcare providers advising on ENDS use as a cessation tool.

United States Tobacco Cessation Plans

In the U.S., the American Lung Association (ALA) releases an annual State of Tobacco Control report that evaluates tobacco control policies at the federal and state levels. Key findings and recommendations include:

• The federal government should implement a comprehensive tobacco control plan, including increasing tobacco taxes, funding tobacco prevention and cessation programs, and regulating tobacco products.
• States should implement and enforce smoke-free laws, increase tobacco taxes, and fund tobacco prevention and cessation programs.
• The COVID-19 pandemic highlighted the importance of quitting smoking and the need for increased access to cessation resources.

Proposed Role of Vapes In US Tobacco Cessation Plan

In contrast to the U.K.'s approach, the U.S. Food and Drug Administration (FDA) has taken a more cautious approach to approve the use of ENDS (electronic nicotine delivery systems) for tobacco cessation. While the FDA recognizes that ENDS may help some smokers quit, they have expressed concerns about the potential risks and uncertainties surrounding ENDS use, particularly among young people.

The FDA has said that the use of ENDS should only a last resort for smokers who cannot quit using other FDA-approved nicotine replacement therapies, such as nicotine gum or patches. In the FDA's view, the risks of nicotine addiction and the potential for young people to start tobacco use outweigh ENDS use as a cessation tool.

In June 2021, the FDA released a report on youth vaping in America, highlighting young people's continued use of ENDS as a public health concern. The report emphasized the need for stronger regulation of ENDS, including restrictions on flavored ENDS (vape) products and stricter enforcement of age verification requirements for ENDS sales. The FDA also announced that they would be conducting a comprehensive review of the safety and effectiveness of ENDS as a tobacco cessation tool to supply more explicit guidance to healthcare providers and the public. This comprehensive review is yet to be released by the FDA.

How Have Tobacco Companies Shaped the Vape Market?

The tobacco industry's influence over ENDS systems’ regulation has been controversial, with concerns about their marketing practices, product safety, and lobbying efforts. While adult consumers argue that vape devices help reduce smoking prevalence, others (parents, tobacco lobbyists, and congressmen), have called for stricter regulations to protect “public health.”

There have been concerns about the role of the U.S. tobacco industry’s efforts in reducing availability of competitive vape ENDS systems while not supplying better alternatives itself. It is important to note that the most popular vape products owned by large tobacco companies are vape pods such as Juul and Vuse.

In Summary

While both the U.K. and the U.S. acknowledge the potential of ENDS as a cessation tool, they have taken drastically different approaches to its use. The U.K. sees ENDS as a practical option for smokers who are unable or unwilling to quit smoking, while the U.S. is more cautious about the potential risks and has called for stricter regulation of ENDS to protect young people.

The specific policies and priorities do differ between the two countries. Both the U.K. and the U.S. are taking a multi-faceted approach to reducing tobacco use, including implementing policies to regulate tobacco products, funding tobacco control initiatives, and supplying support for smokers to quit.

Ironically, the alternative to the vape products that U.S. anti-vape groups are trying to shut down, are the same tobacco products that started the problem to begin with. So, if the anti-vape constituents can outlaw vaping, the alternative product most vapers are expected to go back to is tobacco (traditional combustible cigarettes). The irony is not lost on me (an ex-smoker who now hates the smell of tobacco).

The US Government anti-vape groups suggest ex-smokers should use the ENDS solutions already available and approved by the FDA: gum, patches, prescription medicines and other ENDS products already available on the market and approved by US policy makers. In answer to them (as an ex-smoker) I can say they didn’t work for me. If gum worked, we wouldn’t have had to invent vaping. The staggering decrease in cigarette consumption across the United States happened after the invention of the e-cigarette, not the nicotine gum or patch.

Take away my vapes and I’ll probably go back to smoking cigs for my nicotine consumption. Not my first choice, but it seems that could be the only legal solution that our US government will leave me for my nicotine addiction.