Vape and Tobacco Free Zones Consultation
- Maelie Dawkins-Wood
- 1 day ago
- 6 min read
Written by Maelie Dawkins-Wood
Drug Science Response
The consultation document opens with the case for change, that “people deserve to live in a fairer UK, where everyone lives well for longer.” We agree with this statement. We do not agree that treating reduced risk products – vapes and heated tobacco products -in the same way as cigarette smoking will achieve this vision.
The Department of Health and Social Care is correct that smoking is a uniquely harmful way of consuming nicotine and remains the leading cause of preventable death and disease in the UK. It is estimated that two in three long-term smokers will die as a result of their smoking (NHS, 2023). Reduced risk nicotine products, particularly vapes, and to a lesser extent heated tobacco products (HTPs), and nicotine pouches are very different to the combustible cigarette, and have emerged as useful tools to mitigate smoking, and support smoking cessation. In relation to vapes, there is strong evidence that they are more effective than nicotine replacement therapy (NRT) to support long-term quitting (Lindson et al., 2025). Vapes and HTPs deliver nicotine without combustion, which is the primary source of harm from smoking. There is a well-recognised continuum of risk across nicotine products, with combustible cigarettes at the highest end, and NRT at the lowest end. HTPs and vaping products are substantially lower risk than cigarette smoking and sit at the lower end of the risk spectrum (Abrams et al., 2018; Nutt et al., 2014; RCP, 2016). Incorporating lower-risk nicotine alternatives within a harm reduction framework, rather than implementing further restrictions to their use, fits with the DHSC’s stated objective of providing a fairer UK, where everyone lives well for longer. Disaggregating vapes and heated tobacco from lethal cigarette smoking by permitting their use in some places where smoking is not allowed, supports, rather than stigmatises smokers, consistent with the UK’s world-leading position on harm reduction. We believe that a risk-proportional approach should be taken to policy making.
Smoke-free places
While it is well established that second-hand smoke is most hazardous in enclosed environments, evidence indicates that it can reach meaningful concentrations in certain outdoor settings, including crowded spaces or areas with partial enclosure, such as building entrance ways or public transport stops (Sureda et al., 2013). However, in open, non-crowded outdoor spaces there is limited evidence that second-hand cigarette smoke causes significant harm, thus any policy to make these areas smoke-free is based the denormalisation of smoking rather than harms.
A substantial body of evidence suggests that reducing the visibility of smoking in public spaces is associated with shifts in social norms, particularly among young people, and can reduce the likelihood of smoking initiation (Wakefield et al., 2010). By limiting where smoking is permitted, such policies reinforce the perception of smoking as an undesirable or outdated behaviour, aligning with broader tobacco control strategies. This is consistent with recommendations from the Royal College of Physicians, which emphasises the importance of population-level measures in changing social attitudes towards smoking.
Furthermore, increasing practical barriers to smoking may support cessation efforts. Environmental restrictions, such as fewer permissible smoking locations, introduce friction into habitual smoking patterns, which can prompt reflection and reduce consumption. Evidence suggests that comprehensive smoke-free policies are associated with increased quit attempts and reductions in smoking prevalence (Frazer et al., 2016). While outdoor bans alone are unlikely to produce large cessation effects, they can act synergistically with other interventions such as cessation via nicotine replacement therapy.
Reduced risk nicotine products – HTPs and vapes
Whilst we broadly agree with extending smoke-free areas, it is important that people who smoke are supported with access to alternative, lower-risk sources of nicotine without overly cautious restraints on their use. This can help to ensure compliance and reduce unintended consequences of extending smoke-free places. This is because when nicotine dependence is not adequately addressed, individuals may be more likely to circumvent restrictions or disengage from services. Harms to the user from vaping are known to be substantially lower than from smoking, with risks to bystanders considerably less. There is no health reason for outdoor restrictions on places where adults can vape.
In Great Britain, common reasons for vaping among ex-smokers include quitting smoking and preventing relapse, and in the 2025 ASH survey, 60% of ex-smokers who had quit in the previous five years using a vape were still vaping. A 2026 secondary analysis of a large UK randomised trial found that continued e-cigarette use after quitting smoking was associated with a lower risk of relapse to smoking (Bunce 2024). Implementation of policies that make these reduced-risk products harder to use, more stigmatised, or only possible in places were smoking is allowed, has the potential to undermine abstinence for former smokers and possibly be harm-promoting.
Restrictive measures, in this case, including HTP and vape use in smoke-free areas implicitly suggests a harmful product, comparable with smoking. Evidence already shows that misperceptions of relative harms are a significant barrier to switching to vaping, with individuals who believe vaping is as harmful as smoking being less likely to attempt cessation using lower-risk alternatives (East et al, 2026). It is easy to see how including restrictions on vaping and heated tobacco products in outdoor spaces may unintentionally reinforce this false harm-equivalence between cigarettes and other nicotine products. Fewer smokers switching, weakens harm reduction efforts and negatively impacts public health outcomes. The 2016 Royal College of Physicians report stated this clearly, “Anything that makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, then it causes harm by perpetuating smoking” (2016, p. 187). Regulation must therefore be carefully calibrated to avoid producing unintended consequences that preserve smoking prevalence rather than reducing it.
The evidence-base on HTPs is less extensive but it is reassuring that the U.S. FDA has authorised the IQOS product ‘Modified Risk Tobacco Product’ (MRTP) status. This means that after extensive review, the FDA recognises that use of the product reduces the production of harmful and potentially harmful chemicals and that switching from smoking to the IQOS system significantly reduces a person’s exposure to these chemicals. While there is a research basis for restricting HTP use indoors, the case for outdoor bans is much weaker. HTP use has been reported to cause second-hand symptoms such as coughing, sore throats and nausea in ‘very small’ enclosed spaces (Imura & Tabuchi 2021). Research also shows trace amounts of nicotine (not a known carcinogen) can be found in others when HTPs are used in small, confined spaces (Yoshioka et al, 2023). This evidence demonstrating measurable exposure and health effects is based on ‘indoor’ or ‘close proximity’ environments, where aerosol can accumulate, thus policies to protect vulnerable groups is understandable. Conversely, scientific literature does not currently provide strong evidence that outdoor HTP use poses a comparable population-level risk to justify outdoor bans.
Overall, we believe that a risk-proportional approach should be taken to policy making. Restrictions on cigarette-smoking in outdoor areas is justifiable since it can discourage the most harmful behaviour. Treating reduced risk nicotine products in the same way is not based on evidence of harm, is overly coercive, and sends the wrong message that HTPs and vapes are as harmful as smoking. Decisions regarding the use of vaping products and HTPs should be left to the discretion of individual establishment owners. Imposing mandatory restrictions creates additional enforcement responsibilities for staff who have not agreed to such measures, potentially detracting from core operational duties.
