Vaping poses ‘only a small fraction’ of the risks of smoking, and NHS trusts should ensure that e-cigarettes and nicotine replacement therapies are available for sale in hospital shops, says a new PHE report. Switching completely from cigarettes to e-cigarettes conveys ‘substantial health benefits’, states the agency’s updated evidence review, with the devices potentially contributing to at least 20,000 successful quits per year. However, use of e-cigarettes in the UK has plateaued at just under 3m and there is substantial public misunderstanding on the issue. Less than 10 per cent of adults are aware that most smoking-related health harms are not caused by nicotine, it says, with ‘many thousands’ of smokers incorrectly believing that vaping is as harmful as smoking. Around 40 per cent of smokers have yet to try an e-cigarette, the report estimates, adding that the evidence ‘does not support’ concerns that the devices are potential routes into smoking for young people. The highest levels of quit success are among smokers who combine e-cigarette use with support from local smoking cessation services, it says. ‘Local authorities should continue to fund and provide stop smoking services in accordance with the evidence base,’ the document states. However a recent report from Cancer Research UK and ASH found that cuts to the public health budget had meant ‘dramatic’ changes service provision, with at least one council now having ‘zero budget’ to address smoking (DDN, February, page 5). ‘Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95 per cent less harmful, and of negligible risk to bystanders,’ said PHE’s director for health improvement Professor John Newton. ‘Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know. It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.’ E-cigarettes and heated tobacco products: evidence review at www.gov.uk * Should e-cigarettes be provided free to smokers who cannot or will not quit? See Neil McKeganey's article in our latest issue.