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Reduced Risk Confirmation

The UK’s the independent Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment has released a report stating vaping offers reduced harm to smokers

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The United Kingdom’s independent Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) looked at electronic nicotine and non-nicotine delivery systems and found vaping products “are likely to reduce the harm to health if used as a replacement for conventional cigarettes”.

The COT is a committee of independent experts that provides advice to the Food Standards Agency, the Department of Health and Social Care and other government departments and agencies on matters concerning the toxicity of chemicals in food, consumer products and the environment.

Members are required to follow the Code of Conduct for scientific advisory committees. As part of this, they must declare any potential conflicts of interests, and depending on the nature of such conflicts, they may, at the chairman's discretion, be excluded from the discussion and formulation of the Committee’s conclusions and recommendations in relation to relevant agenda items.

The COT was commissioned by the Department of Health and Social Care and Public Health England to assess the potential risk to health from nicotine and non-nicotine e-cigarettes.

The COT report today finds that switching from conventional cigarettes to e-cigarettes is likely to reduce health risks but highlights that some risks will be reduced more than others. For example, the risk of developing lung cancer is likely to be reduced more than the risk of triggering asthma symptoms.

The report says:

  • E-cigarette users who do not already use tobacco products risk negative effects on their health – but those risks are unknown
  • The possible health risk of inhaling flavouring ingredients used in e-liquids - substances which are mostly approved for consuming in food but not for inhalation - is (also) as yet unknown, particularly in the long term
  • Health risk to bystanders from vaping is low in most situations although some effects from high exposure to nicotine in the air may occur such as an increased heartrate

Professor Alan Boobis, Chair of the COT, said: “Our assessment on e-cigarettes largely reinforces the scientific consensus to date on their relative safety, that while not without risk they are significantly less harmful than smoking. On the types of effects, our assessment shows that e-cigarette users might experience similar types of effects on their health as can occur from smoking conventional cigarettes, such as an increase in signs of respiratory and cardiovascular disease, particularly in those suffering from these conditions, or local irritation such as a burning sensation in the throat, nose, or eyes. But our study does provide reassurance that the health risks to bystanders from the vapour is generally low.”

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

Most e-cig users are former tobacco smokers. When longitudinal data is examined, e-cig users may demonstrate an increased cardiovascular rate above and beyond non-smokers, but how much of this is due to the prior effects of tobacco smoking is unknown.

“The two key points that this report should have highlighted are that the cardiovascular event rate for e-cig users may be higher than non-smokers but it has repeatedly been demonstrated to be lower than tobacco cigarette smokers, and that the impacts seen in e-cigarette users may also be due to prior tobacco use.

“The report correctly highlights that, as a comparative risk, vaping is less harmful than smoking tobacco cigarettes.”

Dr Nicholas Hopkinson, Reader in Respiratory Medicine at Imperial College London, said:

The UK Committee on Toxicity report on vaping finds that ‘In considering the comparison of E(N)NDS use with cigarette smoking...the relative risk of adverse health effects would be expected to be substantially lower.’ This supports the current UK consensus and the position taken by The Royal College of Physicians in its report ‘Nicotine without the Smoke’ [link].

Most people who vape are either smokers trying to quit or ex-smokers. Smokers who switch completely to vaping will get a substantial health benefit. However, no serious authority suggests that vaping is completely harmless, so people should try to quit vaping too if they can in the long-term, though not at the expense of going back to smoking.

Continued regulation of e-cigarette manufacture, contents and marketing including via the provisions of the EU Tobacco Products Directive is important as well as efforts to identify and reduce or eliminate any toxic components in e-cigarette vapour to minimise the remaining risk as far as possible.

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

The new report from Public Health England confirms current scientific consensus: namely that electronic cigarettes appear less harmful than traditional cigarettes but are not risk-free.

“This evidence is consistent with current public health advice suggesting people who smoke consider switching to electronic cigarettes, but that people who do not smoke cigarettes should not start vaping.

“Cigarettes kill 1 in 2 regular smokers, but much of this risk can be reduced by quitting, even in later life, so it is incredibly important that people who smoke have access to evidence-based stop-smoking support and treatments.

“It is not just people who smoke cigarettes who are at risk from cigarette smoking – the World Health Organisation estimates exposure to second-hand smoke causes 600,000 deaths a year. Evidence from this new report does not suggest considerable harm from vapour to bystanders.”

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

This new report confirms that vaping is much less dangerous than smoking. If you are a smoker and find quitting difficult, switching to vaping is the next best option.”

Dr Debbie Robson, Nicotine Research Group, National Addiction Centre, King’s College London, said:

We welcome the COT’s comprehensive report and recommendations. Around three and a half million people in the UK vape and for those who do so exclusively, they can be reassured that by switching completely from smoking to vaping, they are doing the best thing for their health and wellbeing. In line with PHE commissioned annual evidence reviews that our group produce, those who both vape and smoke should be encouraged to stop smoking as soon as they can, and people who have never smoked should avoid taking up vaping and never start smoking.”

Prof John Britton, former Director of the UK Centre for Tobacco & Alcohol Studies and Consultant in Respiratory Medicine, University of Nottingham, said:

The findings of this new report confirm that while not harmless, e-cigarettes are substantially less harmful than smoking tobacco. This conclusion firmly endorses the UK policy of recommending vaping as a practical and effective means for smokers to prevent harm from continued nicotine use, and provide welcome, authoritative reassurance that for smokers who find it difficult to quit smoking, vaping is the obvious next best option.”


  • COMMITTEE ON TOXICITY OF CHEMICALS IN FOOD, CONSUMER PRODUCTS AND THE ENVIRONMENT (COT) Statement on the potential toxicological risks from electronic nicotine (and non-nicotine) delivery systems (E(N)NDS – e-cigarettes) – [link]

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Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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