Professor John Britton

Posted 27th September 2019 by Dave Cross
Professor John Britton, Director of the UK Centre for Tobacco and Alcohol Studies, speaks out about vaping and how the U.K. is leading the way in combatting the impact of tobacco-related diseases. He underlined how the rise of ecig use is linked to plummeting smoking rates, and that Australia’s approach is failing the nation’s smokers.

“Smoking kills,” says Professor John Britton. It is so clear and obvious that it is amazing this simple fact is overlooked by so many when vocalising their opposition to vaping. He calls tobacco use “a damaging and irrational behaviour” and notes that it persists in countries across the globe. That it does so is testament “to the power of nicotine addiction”, but also to the failure of nations to embrace an alternative offering substantially less harm.

“Persuading smokers to accept help can … be difficult: most choose to quit unaided, and usually fail,” he tells the British Medical Journal. Consequently, smokers remain smokers until around half are killed by their addiction to smoking. Britton points out that this means, with a current smoking population of around 7 million tobacco users, approximately three and a half million people will lose their lives early through tobacco use. Scaling this up, “one in fourteen people on the planet today may die from tobacco.”

This situation “is prime facie evidence of a systematic failure of public health”.

A damning statement, but unarguable. Public health experts have been failing smokers and, in many countries like India, the USA and Australia, continue to do so. It is laughable that they are so entrenched in their opposition to vaping and nicotine use when, as Britton repeats, the chemical has a similar risk profile to that of caffeine.

“The popularity of electronic cigarettes with smokers has disrupted the markets of both the tobacco and pharmaceutical industries, demonstrating potential to transform the way that nicotine is used in society and, as a result, prevent millions of deaths.”

Simon Capewell responded to John Britton’s arguments with attacks and slurs, something that now appears to be the standard for British anti-tobacco harm reduction academics in journals.

He calls it a “superb example of epidemiological & scientific non-sequiturs” and goes on to invoke his corrupted version of the Precautionary Principle. Impressively, Capewell cites Wikipedia as a source – something that will impress teenagers everywhere who copy-paste their homework.

Capewell appears to have forgotten to cite the most recent study by Hajek et al., the most comprehensive gold standard Randomised Control Trial to date, which found that vaping offered almost double the success rate of quitting when compared to other cessation methods.

Maybe it was because he was busy thinking about the threat to our children (that lacks evidence) or that he was getting excited over being able to name-check Martin McKee. It is odd he considers McKee to be quotable given that in 2014, McKee asked on social media if electronic cigarette use could lead to cocaine addiction [link]!

“The UK experience also demonstrates that electronic cigarettes have a valuable part to play in reducing tobacco smoking and death and disability that smoking causes,” concludes Britton.

It’s a shame that Simon Capewell lacks the capacity to appreciate this.


  • John Britton: Electronic cigarettes and the precautionary principle, BMJ – [link]
  • “A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy”, Hajek et al., - [link]
  • Tobacco Advisory Group of the Royal College of Physicians. Hiding in plain sight: Treating tobacco dependency in the NHS. – [link]
  • “E-cigarettes: an evidence update. A report commissioned by Public Health England” – [link]
  • “Nicotine without smoke – tobacco harm reduction”, Royal College of Physicians – [link]
  • Action on Smoking and Health. Use of e-cigarettes (vapourisers) among adults in Great Britain – [link]
  • “Adult Smoking Habits in Great Britain 2017”, Office for National Statistics – [link]
  • “Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015-2017”, by Bauld et al. – [link]

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker