2024 saw positive trends in smoking reduction, with vaping continuing to play a significant role in helping individuals quit smoking. Ongoing technological advancements in vaping products, coupled with evidence-based regulatory measures in some countries, aim to maximise the benefits of vaping as a harm-reduction tool while addressing associated risks. However, global progress remains hindered by misinformation and resistance from organisations like the World Health Organisation, which continue to oppose harm-reduction strategies. Despite these challenges, countries with progressive policies, such as Sweden, Japan, and New Zealand, provide hope for a future where effective tobacco control embraces innovation and reduces smoking-related harm on a global scale.
Key Trends and Discussions on Vaping in 2024
1. Harm Reduction and Smoking Cessation:
Vaping continues to be recognised as a significantly less harmful alternative to smoking and an effective tool for quitting. Studies show that it dramatically reduces exposure to the toxic chemicals found in combustible tobacco. Health organisations such as the NHS and Cancer Research UK emphasise that while vaping is not risk-free, it presents a much lower risk profile compared to smoking.
2. Youth Vaping Concerns:
Youth vaping remains a concern globally. However, the evidence suggests that most vaping by non-smoking youths is experimental and infrequent. Regular use is uncommon among those who have never smoked. There has been an increase in calls for stricter regulations to curb youth access while maintaining adult smokers’ access to harm-reduction tools.
• The Gateway Theory: One of the most common concerns surrounding youth vaping is the “gateway theory,” which suggests that vaping serves as a stepping stone to smoking. However, extensive research has debunked this theory. Studies indicate that the vast majority of young people who vape do not go on to smoke combustible cigarettes. Some evidence suggests that vaping may help to prevent smoking in some cases, as young people who use vaping products are less likely to take up smoking compared to those who have never vaped. The gateway theory has been largely discredited by multiple scientific reviews, highlighting that vaping does not lead to smoking for the majority of youth.
Study:
"In conclusion, we report for the first time joint smoking–vaping prevalence from the two most important CDC-sponsored national survey series. The results show that cigarette smoking declined sharply, especially among high schoolers and emerging young adults, while vaping increased substantially."
"Conclusions Population-level data continue to suggest that smoking prevalence has declined at an accelerated rate in the last decade in ways correlated with increased uptake of e-cigarette use."
Jukka Kelovuori has several studies in a thread on X, all of which debunk the “gateway” theory.
3. Regulatory Landscape:
• Australia: In Australia, the vaping regulations have shifted to a model where nicotine-containing e-cigarettes can only be obtained through a pharmacy. This approach has faced criticism for creating a black market, with experts calling for reform to adopt a more regulated consumer model that allows easier access to vaping as a harm-reduction tool. Over 200 firebombings in Australia have also been due to overzealous laws. https://www.aliveadvocacymovement.com/firebombings
• United Kingdom: The UK introduced new measures to discourage youth vaping while continuing to promote vaping as a smoking cessation tool.
• Sweden: Sweden is recognised for its progressive approach, promoting vaping as part of a comprehensive harm-reduction strategy. With the high adoption of snus (a smokeless tobacco product), Sweden has led the way with policies that support less harmful alternatives to smoking. Swedish health authorities emphasise the importance of providing smokers with alternatives like vaping and snus, viewing them as less risky compared to smoking combustible cigarettes.
• Japan: Japan has taken a cautious but generally supportive approach to vaping. While the sale of nicotine e-liquids is banned, the use of non-nicotine e-cigarettes is legal. There is a growing acceptance of harm-reduction strategies, especially with the introduction of heated tobacco products like IQOS, which have gained significant market share. Japan has a strong focus on reducing smoking rates and offering alternatives, but its regulatory framework remains restrictive regarding vaping products.
. USA: Cigarette smoking reached the lowest level ever recorded by the survey @CDCgov NYTS, with only 1.4% of students reporting current use in 2024. The findings showed current e-cigarette use decreased from 2.13 million (7.7%) youth in 2023 to 1.63 million (5.9%) youth in 2024
4. Misinformation and Public Perception:
Misconceptions about vaping persist. Claims like vaping being “just as harmful as smoking” or causing conditions like “popcorn lung” have been debunked repeatedly. Popcorn lung has never been linked to vaping. Accurate representation of vaping’s risks and benefits remains crucial to supporting smokers and informing the public.
Many NGOs continued to resist vaping despite overwhelming evidence supporting its role in reducing smoking-related harm. Their pushback often stems from entrenched ideologies, misinterpretations of harm, or conflicts of interest tied to traditional anti-tobacco funding and partnerships.
Mike Bloomberg has spent billions funding anti-vaping campaigns, focusing on youth use and pushing for strict regulations or bans. His efforts include:
1. Funding NGOs: Groups like the Campaign for Tobacco-Free Kids lobby for flavour bans, higher taxes, and stricter laws on vaping.
2. Influencing Policy: His money helps shape laws and global health policies, often through his partnership with the World Health Organisation (WHO).
Criticisms
• Ignores Harm Reduction: Bloomberg’s campaigns overlook how vaping helps adults quit smoking, especially in countries with high smoking rates.
• Spreads Fear: His funded efforts often exaggerate vaping risks while downplaying its benefits compared to smoking.
• Global Harm: Bans supported by Bloomberg’s funding in countries like India force smokers to stick with deadly cigarettes.
5. Health Impacts:
Research confirms that vaping does not produce the high levels of toxic chemicals associated with smoking and significantly reduces exposure to harmful substances. Questions about long-term effects remain, but current evidence strongly supports vaping as a safer option.
6. Global Perspectives:
• New Zealand and the UK: Both countries continue to lead in harm-reduction strategies, emphasising regulated access to vaping products.
• Australia: Struggles with the current model have prompted calls for reform to improve access while tackling the black market issue.
• Sweden: Sweden stands out as a model of harm-reduction policy in Europe, focusing on providing safer alternatives for smokers. With a relatively high acceptance of snus and vaping, Sweden continues to lead in policies that encourage switching from smoking to less harmful products.
• Japan: Japan has taken a more conservative approach compared to other countries but has shown openness to harm-reduction products like heated tobacco and non-nicotine e-cigarettes. The government continues to focus on public health, reducing smoking rates, and providing alternatives, though its regulations on vaping remain more restrictive than in some other nations.
Looking Ahead:
The debates surrounding vaping are unlikely to abate in 2025. Advocacy for balanced regulations that address youth vaping concerns while promoting vaping for smoking cessation is gaining traction globally. Misinformation remains a significant hurdle, often perpetuated by organisations such as the World Health Organisation, whose overly cautious stance risks undermining harm-reduction efforts. The Framework Convention on Tobacco Control (FCTC), originally established to combat the global tobacco epidemic, has faced widespread criticism for failing to adapt to the emergence of safer alternatives such as vaping. Its rigid policies and refusal to embrace harm reduction as a viable strategy have left many smokers without access to life-saving alternatives, thereby perpetuating smoking rates in countries heavily influenced by its directives.
Despite these challenges, public health campaigns and research are helping to reshape narratives around vaping, highlighting its potential to save millions of lives by reducing smoking rates. Countries like Sweden, Japan, and New Zealand, with progressive harm-reduction policies and evidence-based approaches, could serve as exemplary models for others in navigating these complex issues and achieving meaningful public health gains. The failure of the FCTC to embrace innovation underscores the urgent need for a more pragmatic and inclusive approach to tobacco control—one that prioritises reducing harm over maintaining ideological rigidity.
Here’s to a tobacco harm-reduced 2025, where science, ethics, and compassion triumph over misinformation and fear.