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6 People attempting to quit smoking without professional help are approximately 60% more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over- the-counter nicotine replacement therapies such as patches or gum Survey data commissioned by Action on Smoking and Health in the UK 13 also supports a good news story about people quitting smoking. 700,000 vapers are ex-smokers in Britain (~7% of smokers): ASH estimates that there are currently 2.1 million adults in Great Britain using electronic cigarettes. Of these, approximately 700,000 are ex-smokers while 1.3 million continue to use tobacco alongside their electronic cigarette use. Electronic cigarette use amongst never smokers remains negligible 2.4 What is the potential? The report by Britton and Bogdanovica for government agency Public Health England concluded 14. Smoking kills, and millions of smokers alive today will die prematurely from their smoking unless they quit. This burden falls predominantly on the most disadvantaged in society. Preventing this death and disability requires measures that help as many of today’s smokers to quit as possible. The option of switching to electronic cigarettes as an alternative and much safer source of nicotine, as a personal lifestyle choice rather than medical service, has enormous potential to reach smokers currently refractory to existing approaches. The emergence of electronic cigarettes and the likely arrival of more effective nicotine-containing devices currently in development provides a radical alternative to tobacco, and evidence to date suggests that smokers are willing to use these products in substantial numbers. Electronic cigarettes, and other nicotine devices, therefore offer vast potential health benefits, but maximising those benefits while minimising harms and risks to society requires appropriate regulation, careful monitoring, and risk management. However the opportunity to harness this potential into public health policy, complementing existing comprehensive tobacco control policies, should not be missed. It is not only public health experts. One Wall Street analyst, Bonnie Herzog of Wells Fargo Securities, projects that vapour use will surpass smoking (in the US) within a decade (by which she means 2023)15. Much will depend on whether regulation encourages or suppresses innovation – and her forecast is contingent on an effective pro-innovation regulatory framework. In March 2014 she said: Bottom line: if regulations don't stifle innovation, we continue to believe e-vapor consumption could surpass combustible cig consumption in the next decade, driving total profit pool growth and generating a roughly 7% CAGR. If vaping came close to overtaking cigarette use, it would be one of the most remarkable disruptive public health technologies of modern times. smoking cessation: A cross-sectional population study. Addiction109: [link] 13 ASH (UK) Fact sheet: Use of electronic cigarettes in Britain, July 2014 [link] 14 Britton J, Bogdanovica I. Electronic cigarettes: A report commissioned by Public Health England. May 2014 [link] 15 Cited in The Economist, Kodak moment, 23 September 2013. [link]