For over a decade, the United Kingdom has been widely regarded as a global leader in tobacco harm reduction. By recognising that non-combustible nicotine products are significantly less harmful than cigarettes, policymakers helped millions of smokers move toward safer alternatives such as e-cigarettes.
Now, new evidence suggests those policies continue to deliver measurable results. Yet at the same time, regulatory momentum across Europe and within the UK itself, appears to be drifting away from the very strategy that made the country a public health success story.
“Swap to Stop”: Proof that harm reduction works
Fresh research from the National Institute for Health and Care Research (NIHR) Policy Research Unit in Addictions, based at King’s College London and University College London, provides one of the clearest examples yet of harm reduction in action. Published in the journal Addiction, the study examined the impact of the UK government’s renowned Swap to Stop programme, which provides free vape starter kits combined with behavioural support, to smokers wishing to quit.
Using data from the Smoking Toolkit Study, a long-running national survey that conducts monthly interviews with adults in England, researchers analysed quitting behaviour before and after the scheme’s introduction in December 2023. Their findings were striking.
In the year following the programme’s launch, approximately 125,000 additional people in England began using vapes to try to quit smoking. Researchers observed a sustained 1.5 percentage-point increase in the proportion of smokers using vaping as a quitting method.
Professor Leonie Brose, Professor of Addictions and Public Health at King’s College London and the study’s senior author, emphasised the importance of even modest population-level shifts. Smoking, she noted, kills more than half of long-term users, meaning relatively small behavioural changes can translate into significant public health gains.
Vaping succeeds where traditional NRTs fail
Several clinical trials and population studies have demonstrated that smokers who switch to vaping are significantly more likely to quit than those relying on conventional nicotine replacement therapies such as patches or gum.
.The findings also reinforce a growing body of evidence suggesting vaping can outperform traditional cessation tools. Several clinical trials and population studies have demonstrated that smokers who switch to vaping are significantly more likely to quit than those relying on conventional nicotine replacement therapies such as patches or gum.
Another study found that around one in five smokers successfully quit when provided with free vape devices combined with professional support. Dr Vera Buss, Senior Research Fellow in Behavioural Science at University College London and lead author of this study, highlighted that given the well-documented health risks of smoking—including cancer, cardiovascular disease and respiratory illness—the potential population health impact of successful quitting is enormous.
Local authorities want to expand vape-based quit services
The national scheme is also being mirrored at local government level. In North Yorkshire, council officials are considering spending up to £477,000 on vapes to support residents trying to quit smoking as part of the Living Well Smokefree programme. Since vaping was incorporated into the service in July 2023, 487 participants have used e-cigarettes to quit smoking, with around one-third remaining smoke-free after a year.
To this effect, a council report recommends launching a procurement process to secure a supplier of vape devices and related products, with a proposed contract running from July 2026 to July 2029. Eligible participants would receive online vouchers for rechargeable vape devices and supplies, funded through ring-fenced public health budgets. The initiative is part of the government’s broader Smokefree Generation strategy, which aims to reduce the national smoking rate to 5 per cent by 2030.
How can this success be ignored?
Meanwhile, given the growing body of evidence in favour of vaping for smoking cessation, it is increasingly puzzling that parts of the UK policy conversation appear to be moving in a more restrictive direction. New regulatory debates around flavours, marketing restrictions and retail visibility risk undermining the same harm-reduction tools that have helped drive smoking rates downward. In Europe, similar restrictions have already produced worrying consequences.
Similarly, across the border in Ireland, the government recently approved publication of the Public Health (Tobacco Products and Nicotine Inhaling Products) (Amendment) Bill 2026, which would introduce sweeping restrictions on reduced-risk nicotine products.
The proposed legislation includes bans on retail advertising and point-of-sale displays, as well as strict rules governing device appearance and packaging. It would also limit flavours for nicotine inhaling products to tobacco only, removing many options used by adults trying to quit smoking. Sales of nicotine pouches and other nicotine products would also be prohibited for people under 18.
Prohibition = illicit trade
Tobacco harm reduction experts are, of course, highlighting that these policies repeat mistakes already observed elsewhere. The international coalition Prohibition Does Not Work (PDNW)—a group of think tanks and policy experts—warns that similar restrictions in countries such as the Netherlands, Australia, Mexico and Brazil have produced consistent outcomes: illicit markets expand, consumers lose access to regulated products, and smoking declines stall.
Consumer research conducted with the involvement of Irish addiction specialist Dr Garrett McGovern highlights the risks. Survey data suggests around one-third of Irish vapers would return to smoking if flavour bans were introduced. At the same time, 49 per cent say they could obtain banned products from overseas or cross-border retailers. PDNW spokesperson Tim Andrews said that these findings should serve as a warning to policymakers.
The bottom line
Ultimately, at the centre of the debate lies a fundamental scientific distinction. Nicotine itself is not the primary cause of smoking-related disease. The overwhelming health damage comes from combustion—the process of burning tobacco that releases thousands of toxic chemicals in cigarette smoke.
Products that eliminate combustion dramatically reduce risk. Yet policymakers are seemingly choosing to ignore these facts. Treating smoke-free nicotine products as if they were cigarettes ignores decades of scientific evidence and risks undermining one of the most promising strategies for reducing smoking-related illness.
A strategy worth protecting
The UK once stood as a global example of how harm-reduction policies could dramatically accelerate declines in smoking. The results of the Swap to Stop programme demonstrate that the strategy continues to work. Thousands of smokers are attempting to quit, supported by access to safer nicotine alternatives and evidence-based public health initiatives.
Turning away from that model now would be a remarkable reversal. If policymakers are serious about achieving a smoke-free future, the lesson from both research and real-world experience is clear: harm reduction works—and restricting it risks undoing years of progress.
