Royal Physicians: "Large-scale substitution of e-cigarettes, or other non-tobacco nicotine products, for tobacco smoking has the potential to prevent almost all the harm from smoking in society,” the RCP says. “Promoting e-cigarettes…and other non-tobacco nicotine products as widely as possible, as a substitute for smoking, is therefore likely to generate significant health gains in the UK.”

Is vaping safer than smoking?

Royal Physicians: “E-cigarette vapour contains a far less extensive range of toxins, and those present are typically at much lower levels, than in tobacco smoke,” the report notes. “In normal conditions of use, toxin levels in inhaled e-cigarette vapour are probably well below prescribed threshold limit values for occupational exposure, in which case significant long-term harm is unlikely. Some harm from sustained exposure to low levels of toxins over many years may yet emerge, but the magnitude of these risks relative to those of sustained tobacco smoking is likely to be small….Although it is not possible to quantify the long-term health risks associated with e-cigarettes precisely, 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.”

The RCP argues that appropriate safety regulations could further reduce the hazards posed by e-cigarettes. But it warns that if regulation “makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, or inhibits innovation and development of new and improved products, then it causes harm by perpetuating smoking.”

Do e-cigarettes help smokers quit?

Royal Physicians: “Smokers who use nicotine products as a means of cutting down on smoking are more likely to make quit attempts,” the RCP says. “Promoting wider use of consumer nicotine products, such as e-cigarettes, could therefore substantially increase the number of smokers who quit.”

Are e-cigarettes a gateway to smoking?

Royal Physicians: “There is no evidence that either NRT or e-cigarette use has resulted in renormalisation of smoking,” the RCP says. “None of these products has to date attracted significant use among adult never-smokers, or demonstrated evidence of significant gateway progression into smoking among young people.”