LONDON — The stacks of brightly colored disposable e-cigarettes, touting flavors like cotton candy ice and greengrape melon and often looming over the not-dissimilar-looking candy displays, have become a commonplace sight in convenience stores in both the U.S. and the U.K.
But here, they’re on their way out.
The U.K. is moving to ban disposable vapes starting next summer, part of a broader policy push that will also prevent anyone now 15 years or younger from ever being able to buy tobacco products, even once they become adults. The aim — with smoking still killing about 80,000 people nationally every year — is to create what the government has dubbed a “smoke-free U.K.”
The U.K. is targeting disposable e-cigarettes because the colorful, cheap, and flavored products have been blamed for the takeoff in vaping among young adults and youth in recent years. Vapes that can be refilled with new cartridges or tanks will still be available.
“This government is taking bold action to create the first smoke-free generation [and] clamp down on kids getting hooked on nicotine through vapes,” Health Secretary Wes Streeting said in a statement introducing the plans. The government’s proposals are now under consideration in Parliament, where the Labour Party has a large majority.
The phaseout of disposable vapes is stronger action than what’s been seen in the U.S., where thousands of vapes are widely available even though the vast majority are technically illegal, as they have not received the regulatory authorization that any e-cigarettes for purchase are meant to have. It’s an example of how the two countries have diverged in their approaches to e-cigarettes — and their views of the threats and potential benefits that accompany the products.
And it’s not always that the U.K. has been more hostile to e-cigarettes.
In the U.S., much of the messaging around vapes has focused on the dangers that e-cigarettes pose, with campaigns warning about the chemicals they contain, for example. But in the U.K., health officials have emphasized that e-cigarettes are a safer nicotine option than cigarettes, and have encouraged smokers to switch to vaping as a way to lower their health risks. The previous Conservative government launched a “Swap to Stop” program that offered e-cigarettes to smokers, together with behavioral coaching.
Indeed, despite surveys showing that many people — including those who vape — think e-cigarettes are as harmful or even more dangerous than cigarettes, scientific reviews have shown they are safer than smoking, meaning they could reduce health harms if people moved to them from cigarettes. Experts say the use of e-cigarettes in the U.K. has contributed to reducing smoking levels.
E-cigarettes do carry risks, and the long-term health effects of the chemicals in the products are not well understood because vapes are relatively new. Many products also carry high levels of nicotine, increasing their addictive potential. But they contain much lower levels of certain carcinogens, and a recent clinical trial showed that vapes were as effective as Chantix at helping smokers leave cigarettes behind. (Researchers who are more dubious of encouraging people to switch to e-cigarettes note that some people don’t entirely leave cigarettes behind once they start vaping, meaning they expose themselves to the harms of both products.)
But if e-cigarettes can provide an off-ramp for smokers from more toxic cigarettes, the arrival of disposables in the U.K. seemed to draw some people to nicotine use who wouldn’t have smoked in the first place, and also particularly appealed to teens, experts say.
“The advice in this country for many years has been if you smoke, you can substantially improve your health by switching to vaping, but if you don’t smoke, you shouldn’t vape,” said Sarah Jackson, principal research fellow at University College London’s Tobacco and Alcohol Research Group. “And I think we were doing very well with that approach, until quite recently.”
E-cigarettes for years were predominantly used as a cessation tool or by former smokers who had started using nicotine again, Jackson said. Young people perceived them as uncool.
“And that all really changed with disposables,” Jackson said.
Disposables took off around 2020, and in turn, vaping rates among young adults and kids started rising, though they’ve flattened out in the past few years.
Among 11- to 17-year-olds, the proportion who vaped regularly grew from 4.1% in 2020 to 7.0% in 2022, where it’s roughly stayed since, according to the advocacy group Action on Smoking and Health. Overall, one in four 11- to 15-year-olds has tried vaping, according to the National Health Service. Legally, people have to be 18 to buy nicotine-containing e-cigarettes, but age-based restrictions are rarely enforced, experts say.
Among young adults, vaping prevalence shot up from about 10% in early 2021 to nearly 30% by May 2023, with more people starting to vape who had never smoked. In fact, after disposable vapes surged in popularity, the U.K.’s historic declines in nicotine use overall started to reverse.
“Vapes are probably diverting some young people away from ever starting to smoke, which is a good thing, because vaping’s much less harmful for you,” Jackson said. “But for other young people, vaping is probably recruiting them to take up nicotine use when they wouldn’t have otherwise smoked.”
In outlining its plan to ban disposable vapes, the government, in addition to arguing it could prevent young people from picking up nicotine habits, made an environmental case, citing estimates that 5 million single-use vapes are littered or tossed out every week in the U.K.
While experts have largely praised the government’s proposals for tobacco products, some have also said that policymakers need to ensure that they don’t introduce new roadblocks for smokers who could switch to e-cigarettes. The appeal and availability of refillable vapes needs to be maintained for smokers, they say. They also worry about creating the false impression that vapes are so dangerous that some need to be banned, while cigarettes remain for sale.
“We have to focus on the immense harms to health caused by tobacco smoking and avoid putting people off switching to less harmful alternatives, such as vaping,” Caitlin Notley, a professor of addiction sciences at the University of East Anglia, said when the government’s proposals were announced. “Policies to regulate products and limit the marketing so as not to appeal to children are important, but in tightening regulations we must not make reduced harm products harder for adult smokers to access, as this could unintentionally prolong or even increase levels of tobacco smoking.”
The e-cigarette lobby has adopted a similar message, with John Dunne, the director general of the U.K. Vaping Industry Association, saying that disposable vapes’ “accessibility and convenience, particularly amongst low income groups who are the most prevalent smokers, should not be forgotten and highlights the careful balancing act required.” The industry has also warned that the government’s proposals could lead to an increase in black-market vapes being imported.
The embrace in the U.K. of vaping as a safer — if not entirely safe — option for smokers reflects the country’s greater willingness, compared to the United States, to implement harm reduction strategies, like it did with syringe exchange programs when HIV emerged, experts say. In the U.S., “harm reduction for drugs had a more contested policy history,” as a group of experts wrote in a comparison of vaping policies in the U.S., the U.K., and Australia. That history extended to how the U.S. first approached e-cigarettes.
“Although e-cigarettes are a relatively new arrival, they were coming into a kind of context which was already very different,” said Virginia Berridge, a social historian at the London School of Hygiene and Tropical Medicine. In the U.K., “the idea of addiction to nicotine is accepted as a lesser evil than the harms caused by smoking.”
In the U.S., the rise in youth vaping came a few years prior to the surge in the U.K., and was at least in part blamed on the arrival of Juul and its flavored cartridges. Many kids who had picked up vaping then transitioned to disposables when they reached the market.
But while more than a quarter of U.S. high school students reported vaping in 2019, the rate has declined steadily since then, falling to 7.8% this year. The decline in youth vaping in the U.S. has been attributed to campaigns promoting the dangers of vaping, as well as state and city bans on flavored vapes — though, as STAT has reported, flavored e-cigarettes have still been easy to find in those places.
As youth vaping has tapered off, the U.S. Food and Drug Administration has signaled more acceptance of the utility of e-cigarettes as smoking-cessation tools. Overall, the FDA has approved some three dozen tobacco- and menthol-flavored e-cigarette products and devices for sale in the U.S. as alternatives to cigarettes, while the agency, along with U.S. law enforcement, has been aiming to take more action against illegal vapes.
Some advocates in the U.S. have argued the country should follow the U.K. in banning disposables as well.
“Disposables are available in an incredible range of flavors that kids want, and that increases youth use,” said Eric Lindblom, a former FDA tobacco adviser and a senior scholar at Georgetown University Law Center. “It’s a much smaller price hurdle for kids to get them, they’re much cheaper than cartridge-based or tank-based. And if you get rid of all disposables, then an enforcement official or a customs official, if they see any disposable, they can immediately seize it.”
“It is the smartest, most logical step to do,” he said.
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