June 9, 2022

expert reaction to the Khan review of smoking in England

The UK Government have published the Khan review, an independent review by Dr Javed Khan into the government’s ambition to make England smoke free by 2030.

Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:

“This is a list of sensible and important recommendations. The key innovation is the recommendation that smokers are actively encouraged to switch to vaping. It is likely that within the next decade or so, reduced risk nicotine products will improve further in providing smokers with what they seek from cigarettes. Such products will then replace smoking altogether and the horrific epidemic of lung disease, heart disease and cancer caused by smoking will finally end.”

Dr Jamie Hartmann-Boyce, Senior researcher in Health Behaviours and Managing Editor of the Cochrane Tobacco Addiction Group, University of Oxford, said:

“The recommendations in the Khan review are welcome and supported by evidence. Historically a leader in tobacco control, England must do more to tackle smoking and its major contributions to death, disease, and health inequalities.

“Smoking is a complex problem, and there is no one magic bullet. We know that comprehensive, multi-pronged tobacco control approaches are needed to achieve success, and the report’s recommendations represent such an approach. All recommendations in the report need to be enacted – as the report notes, this requires significant investment.

“Most adults who smoke want to quit, but many find it extremely difficult to do so. Behavioural support of the kind provided by stop smoking services, combined with medications such as nicotine replacement therapy, are the best ways to increase chances of successfully quitting. These services have suffered from decreased investment over recent years. The Khan report recommends additional ringfenced funding to such services, which are critical to helping as many people as possible to quit smoking.

“The report recommends offering vaping as a substitute for smoking as a critical intervention. Though not risk free, evidence overwhelmingly suggests that nicotine e-cigarettes are substantially less harmful than smoking. The harm from smoking comes from the burning of tobacco, and not the nicotine. A growing body of evidence shows that nicotine e-cigarettes can help people stop smoking.

“Preventing people from taking up smoking is also a central component of the review. A small number of other countries have led the way in increasing age of sale, and to be a leader in tobacco control, it is clear that England should follow suit.”

Prof Jacob George, Professor of Cardiovascular Medicine and Therapeutics at University of Dundee Medical School, said:

“I welcome the positive recommendation of vaping as a substitute for smoking and more importantly, providing accurate information on the benefits of switching from tobacco cigarettes to vaping. There is reasonably good quality evidence to support this move but also a lot of misinformation in this area. I hope devolved governments will take notice of these recommendations.”

Prof Jamie Brown, Director of the Tobacco and Alcohol Research Group at UCL, said:

‘I thank Javed Khan for leading this important review and recognising that allowing 64,000 people to die each year from diseases caused by smoking is completely unacceptable. We urgently need bold new tobacco control policies and substantial investments to help the 6 million people still smoking in England to avoid a lifetime of smoking-related diseases, and send a clear signal that smoking is a thing of the past.

“I strongly support the recommendations and comprehensive approach, including four critical recommendations: to urgently invest £125 million per year in a comprehensive Smokefree 2030 programme, including new mass media campaigns and desperately needed support for our under-funded but world-leading stop smoking services, all ideally by a ‘polluter pays’ levy; to raise the age of sale of cigarettes; offering vaping as a substitute for smoking; and for the NHS to prioritise further action to help people quit. Now is the time for the government to act on these bold new proposals.’

https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete

Declared interests

Prof Peter Hajek: “No DOI.”

Dr Jamie Hartmann-Boyce: “I receive research funding from Cancer Research UK, the British Heart Foundation, and the National Institute for Health Research on work related to smoking cessation.”

No others received.