UK must defend safer alternatives that are saving lives worldwide

By Martin Cullip

Over the past decade, the United Kingdom has quietly built one of the world’s most successful public health strategies for reducing smoking.

By embedding vaping into NHS quit-smoking services and recognising the value of safer nicotine alternatives, the UK has driven smoking rates to historic lows while already seeing measurable improvements in health outcomes.

The results are remarkable. Since 2011, adult smoking has nearly halved, falling from 20.2% to 11.9%.[1] Today, around 5.5 million adults vape, with more than half of them having quit smoking completely.[2]

Researchers project that this shift will prevent 166,000 premature deaths by 2052.[3] Already, cardiovascular mortality is down, cancer and COPD deaths are falling and smoking-related hospital admissions have declined by tens of thousands each year.[4] Even short-term studies show benefits: smokers who switch to vaping record significant improvements in blood pressure within a month.[5]

These figures represent thousands of families spared the grief of losing loved ones too soon and an NHS under less strain from preventable illness.

In terms of lives saved and suffering avoided, tobacco harm reduction has become one of the UK’s greatest public health achievements in recent decades.

A new report that I have co-authored with the Smoke Free Sweden movement places the UK’s success alongside examples from Sweden, Japan and New Zealand.

The Safer Nicotine Revolution: Global Lessons, Healthier Futures documents how, wherever safer alternatives have been embraced, smoking has fallen sharply and health outcomes have improved.

In Sweden, smoking rates are now just 5.3%, the lowest in Europe. In Japan, cigarette sales have halved in a decade thanks to heated tobacco. In New Zealand, smoking halved in just six years after vaping was legalised and promoted.

Together with the UK, these countries are all displaying an associated trend of less tobacco-related death and disease. They are proving that harm reduction strategies deliver positive outcomes.

Yet this progress cannot be taken for granted. Ongoing debates in Westminster and Whitehall about restrictions on vapes and other alternatives risk undermining what has been achieved. Excessive regulation, flavour bans or punitive taxation could make safer products less accessible, discouraging smokers from switching and slowing further progress.

This is the lesson that must be delivered when governments meet in November for

COP11, the 11th Conference of the Parties to the WHO Framework Convention on Tobacco Control.

The deniers can no longer claim that harm reduction is just theoretical. It is happening now, with measurable benefits at scale.

If the UK is serious about achieving its smokefree 2030 ambition, it must defend the role of vaping and other reduced-risk products.

The evidence shows that safer alternatives cut smoking, reduce disease and save lives. The UK has displayed global leadership in this field. Now is the moment to protect that achievement and ensure it continues to benefit millions more.

• Martin Cullip is a South London–based consumer advocate and international fellow at the Taxpayers Protection Alliance’s Consumer Center.

 

[1] Office for National Statistics (ONS). Adult smoking habits in the UK: 2023 [Internet]. 2024 Oct 1.[cited 2025 Aug 12]. Available from: https:// www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2023

[2] ASH: Action on Smoking and Health. Use of vapes among adults in Great Britain [Internet]. 2025 Jul [cited 2025 Sep 15]. Available from: https://ash.org.uk/uploads/Use-of-Vapes-Among-Adults-in-Great-Britain-2025.pdf?v=1752070547

[3] Levy D.T, et al. England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking-attributable deaths in England. Addiction [serial online] 2022 Aug 10 [cited 2025 Aug 31]; 116(5): 1196-1211. Available from: https:// pmc.ncbi.nlm.nih.gov/articles/PMC9364758/

[4] Institute for Health Metrics and Evaluation. Global burden of disease results [Internet]. 2021 [cited 2025 Aug 3]. Available from: https:// vizhub.healthdata.org/gbd-results/

[5] George J, et al. Cardiovascular Effects of Switching From Tobacco Cigarettes to Electronic Cigarettes. JACC [serial online] 2019 Nov 15 [cited 2025 Aug 31]; 74(25). Available from: https:// www.jacc.org/doi/10.1016/j.jacc.2019.09.067