May 23, 2024

expert reaction to the report ‘Hooking the next generation: how the tobacco industry captures young customers’

Scientists react to a report published by the World Health Organisation looking at how the tobacco industry captures young customers.

Prof Nick Hopkinson, Professor of Respiratory Medicine, Imperial College London, said:

“Although vaping is much less harmful than smoking, and there is clear evidence from large randomised controlled trials that they can help smokers to quit, WHO is absolutely right to highlight the fact that the tobacco industry is aggressively marketing e-cigarettes to children and young people.

“This is completely unacceptable and governments around the world need to take steps to introduce and enforce regulations to stop this.

“It is unfortunate that back in 2021 the UK government voted down amendments that would have given it power to regulate marketing of e-cigarettes.  It also failed to introduce an excise tax on them, which the chancellor was advised to do last year.

“By calling a snap election, the Prime Minister has stopped the Tobacco and Vapes bill in its tracks.  This would raise age of sale to create a smokefree generation and get a grip on youth vaping.

“Whatever happens at the election, the next government will need to move swiftly to reintroduce these vital public health measures.”

Dr Sarah Jackson, Principal Research Fellow, UCL Tobacco and Alcohol Research Group, University College London, said:

“This report, and the accompanying press release, make claims that do not accurately reflect current evidence on e-cigarettes.

“The report suggests there is ‘insufficient evidence’ that e-cigarettes are effective in helping people to stop smoking. In fact, a Cochrane review on this topic (recognised worldwide as the highest standard in evidence-based healthcare) has concluded that there is ‘high-certainty evidence’ from randomised controlled trials that e-cigarettes increase quit rates compared to nicotine replacement therapy. The most recent version of this review included 88 trials with more than 27,000 participants. This finding is echoed by numerous observational studies that find people who try to quit smoking with an e-cigarette are around twice as likely to be successful in their quit attempt than those who try to quit without using e-cigarettes. In addition, population-level trends show that as more people try to quit smoking with e-cigarettes, the success rate of quit attempts increases.

“The report also suggests it is misleading to suggest that e-cigarettes offer a form of harm reduction compared to smoking cigarettes. Large evidence reviews, conducted independent of industry, consistently conclude that while vaping is not risk-free, it poses only a small fraction of the risks of smoking tobacco.

“The press release states that ‘e-cigarette use increases conventional cigarette use, particularly among non-smoking youth’. That e-cigarettes are a gateway to smoking is a widespread concern, based on observational studies that show young people who vape are more likely to subsequently start smoking than those who do not. However, little evidence currently suggests this association is causal: just because vaping precedes smoking does not mean vaping causes smoking. If that were the case, we would expect to see declines in smoking decrease or reverse when rates of vaping increase. If anything, we currently see the opposite pattern: larger declines in smoking among age groups with greater increases in vaping.”

‘Hooking the next generation: how the tobacco industry captures young customers’, a report by the WHO was published at 15:00 UK time Thursday 23 May,

Declared interests

Prof Nick Hopkinson: “Nick Hopkinson is Chair of Action on Smoking and Health (ASH).”

Dr Sarah Jackson: I have no conflicts to declare.