AL Gor 28 January 2025
Simon Chapman, a prominent public health advocate, has consistently opposed vaping as a harm reduction tool, advocating instead for traditional methods like unassisted quitting or “cold turkey.” Despite growing scientific consensus supporting vaping as a safer and more effective alternative to smoking, Chapman’s claims often reflect ideological stances rather than robust evidence. This critique addresses his most common arguments, supported by specific studies and data.
“Vaping is a gateway to smoking for young people.”
Chapman’s assertion that vaping serves as a “gateway” to smoking is not supported by robust evidence.
Population Data:
A systematic review published in Addiction (2018) found that regular vaping among non-smoking youth is extremely rare. Most young people who try vaping do not progress to regular use, and those who do are typically already at higher risk of smoking due to other factors (e.g., social or environmental).
Declining Youth Smoking Rates:
Public Health England (PHE) (2021) shows that smoking rates among 11–15-year-olds in England dropped from 11% in 2011 to just 3% in 2021. Similar trends have been observed in the United States and New Zealand, where youth vaping rates increased while smoking rates declined (National Youth Tobacco Survey, 2020; NZ Health Survey, 2021).
Causality Misrepresented:
The 2019 National Academies of Sciences, Engineering, and Medicine report concluded that while there is an association between vaping and subsequent smoking in some youth, the evidence does not prove causality. Shared risk factors, such as peer influence or predisposition to risk-taking, likely explain the observed association.
The Australian National Strategy Household Survey 2019-2023 also demonstrates no "gateway" to smoking.
Chapman’s “gateway” hypothesis often ignores these findings and relies on anecdotal evidence or selective data, fostering unnecessary alarm.
2. “We don’t know the long-term risks of vaping.”
While it is true that vaping lacks the 50+ years of longitudinal research available for smoking, substantial evidence already confirms its relative safety compared to smoking.
Toxicological Evidence:
A 2020 review in Nicotine & Tobacco Research found that e-cigarette vapour contains far fewer toxicants than cigarette smoke. For example, levels of carcinogens like formaldehyde and acrolein are reduced by 90–95%.
Biomarkers of Exposure:
A study by Shahab et al. (Annals of Internal Medicine, 2017) compared biomarkers in smokers, vapers, and non-smokers. The results showed that vapers had significantly lower levels of toxic chemicals and carcinogens than smokers, similar to those in non-smokers.
Public Health Endorsements:
Public Health England (PHE) has consistently maintained that vaping is at least 95% less harmful than smoking. The Royal College of Physicians echoed this view in their 2016 report, emphasising that the long-term health risks of vaping are unlikely to exceed 5% of the dangers of smoking.
Chapman’s fixation on long-term unknowns distracts from the clear and present danger of smoking, which kills over 8 million people annually (WHO, 2021).
3. “Vaping normalises smoking-like behaviours.”
Chapman’s claim that vaping “renormalises” smoking behaviours lacks empirical support.
Smoking Trends:
Smoking prevalence has continued to decline in countries with high vaping adoption. For instance, in the UK, adult smoking rates fell from 20.2% in 2011 to 13.3% in 2021 (ONS, 2022), during which vaping became increasingly popular.
Perceptions of Smoking:
Research published in Tobacco Control (2019) found that vaping does not lead to increased positive perceptions of smoking among youth or adults. Instead, vaping is generally viewed as a cessation tool or a distinct activity.
Evidence from Australia:
Australia, where vaping is heavily restricted, has seen slower declines in smoking rates compared to countries like the UK, New Zealand and Sweden. This suggests that restricting vaping may hinder, rather than protect, public health progress.
The “renormalisation” argument appears more ideological than evidence-based, aiming to conflate vaping with smoking despite clear behavioural and cultural differences.
4. “Cold Turkey Is the Most Effective Way to Quit Smoking.”
Chapman often champions unassisted quitting or “cold turkey” as the most effective method for smoking cessation, dismissing vaping as unnecessary. This claim is at odds with both evidence and real-world success rates:
Real-World Data:
A study published in Addiction (2020) found that smokers who used e-cigarettes to quit were 1.5 times more likely to succeed than those who tried to quit cold turkey.
Population Studies:
The 2019 UK Smoking Toolkit Study demonstrated that vaping was the most popular and effective smoking cessation aid in England, with a success rate of 59.7%, compared to 49.4% for prescription medications and 34.6% for unassisted quitting.
Challenges of Cold Turkey:
Research shows that only 3–5% of smokers who quit cold turkey remain abstinent after one year (Cochrane Review, 2021). The low success rate highlights the need for alternative methods like vaping, which address both nicotine addiction and the behavioural aspects of smoking.
The latest study to come out of the UK shows a survey study, including 25 094 smokers aged at least 16 years, found that e-cigarettes were both the most commonly used cessation aid (used in 40.2% of quit attempts in 2023-2024) and associated with the highest odds of successful cessation. By contrast, other aids found to be associated with increased odds of success in quitting smoking were used in less than 5% of quit attempts.
Chapman’s advocacy for cold turkey fails to account for the diverse needs of smokers, particularly those who have tried and failed with unassisted methods.
5. Reframing the Debate: Prioritising Evidence and Ethics
Public health policy must prioritise evidence-based interventions that save lives. Chapman’s focus on the potential risks of vaping, while downplaying the catastrophic harm of smoking, risks perpetuating preventable deaths.
Ethical Responsibility:
With over 1.1 billion smokers worldwide and 8 million annual smoking-related deaths (WHO, 2021), dismissing vaping’s potential is not only scientifically flawed but ethically indefensible.
Policy Recommendations:
Policymakers should embrace vaping as part of a comprehensive harm reduction strategy, following the example of countries like the UK and New Zealand, where vaping is integrated into smoking cessation programmes.
Simon Chapman’s criticisms of vaping reflect an ideological opposition that often disregards evidence and the lived experiences of millions of ex-smokers. His support for cold turkey, as the primary cessation method fails to acknowledge its low success rates and the role vaping, plays in helping smokers quit. A balanced, evidence-based approach is essential to combat the global smoking epidemic and provide smokers with safer alternatives.