informative speech on vaping

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• Health and social care
• Public health
• Health improvement

Minister Neil O'Brien speech on achieving a smokefree 2030: cutting smoking and stopping kids vaping

Neil O'Brien delivered a speech at Policy Exchange on government plans to cut smoking rates and tackle underage vaping.

It’s an enormous pleasure to be here today at Policy Exchange to set out the government’s next steps on vaping and smoking.

Everybody agrees that we must do more to prevent ill health in the first place - not just treat it afterwards.

Cutting smoking is one of the most evidence-based and effective interventions that we can make.

That’s why in 2019 this government set the bold ambition for England to be smokefree by 2030 – reducing smoking rates to 5% or less.

Everyone knows about the health impact of smoking.

It’s still sadly the single biggest cause of preventable illness and death in England.

Up to 2 out of 3 lifelong smokers will die from smoking.

Cigarettes are the only product which will kill you if used correctly.

The positive impact of stopping smoking is immediate. For those who quit, after just a few weeks lung function increases by up to 10% and circulation improves, and the risk of heart attack is half that of a smoker after one year of quitting.

The person who quits today is the person who isn’t in a hospital bed next year. So, cutting smoking will help us hit the fourth of the PM’s 5 priorities – to cut waiting lists.

But as well as the health impact, the economic impact of smoking is also huge.

The excellent 2010 Policy Exchange paper ‘Cough up’ noted that “it is a popular myth that smoking is a net contributor to the economy”.

In fact new analysis from Action on Smoking and Health (ASH) on the costs of smoking in the UK in 2022 found that smoking has a £21 billion total cost to the public purse.

To talk you through that – people used to argue that although there was a cost to the NHS from smoking, the taxes paid offset this.

But this ignores the fact that smokers are more likely than non-smokers to become sick and be out of work, and more likely to stay unwell for longer. Smokers are absent for an average of 2.7 more days per year than non-smokers.

Reducing smoking rates not only improves health outcomes and reduces the burden on the NHS, it also boosts productivity and economic growth, too.

Current smokers are 7.5% less likely to be employed compared to ‘never smokers’, and ex-smokers are 5% more likely to be employed than current smokers.

In places like Birmingham, an additional 6,000 people are out of work because of smoking. Quitting could help to put that right.

As well as the productivity impact, quitting smoking would save the average person around £2,000 a year.

In poorer parts of the country going smokefree could mean far more money circulating in the local economy. There is a positive productivity benefit but also helps to level up across the nation.

Today, as well as tackling smoking, I also want to start to address a new threat - the growth of vaping among children.

There has been a very sharp increase in children vaping - particularly disposable vapes. NHS figures for 2021 showed that 9% of 11 to 15 year old children used e-cigarettes, up from 6% in 2018. That’s a rapidly rising trend we need to stop.

Whether it’s disposable vapes marketed to kids with bright colours, or low prices, or cartoon characters or child-friendly flavours - or indeed products being sold that don’t meet our rules on content.

Today we step up our efforts to stop kids getting hooked on vaping. My message is this: if your business plan relies on getting kids hooked on nicotine, we are coming for you.

So today I will set out:

• what we will do to stop children and non-smokers from starting vaping
• how we will exploit the potential of vaping as a powerful tool to stop smoking
• how we will help more people quit smoking, particularly where rates are highest

I’d like to thank Javed Khan for his independent review which has helped inform many of our next steps.

And I’d also like to thank Bob Blackman in his role as the Chair of the All-Party Parliamentary Group (APPG) on Smoking and Health, who has been a hugely positive advocate for keeping smoking on the public health agenda.

Let me start with vaping.

We need to do 2 things:

• on the one hand, stop children taking up vaping
• on the other, exploit the huge potential of vaping to help adult smokers to quit

NHS figures for 2021, as I mentioned, showed that 9% of 11 to 15 year old children used e-cigarettes in 2021 - that’s a rising trend.

Dr Mike McKean, Vice-President of Policy for the Royal College of Paediatricians and Child Health, has estimated that prevalence may well be even higher now.

I think many of us as parents worry about our kids’ health, about them getting addicted to nicotine. The Chief Medical Officer, who is here today, has also raised concerns about children vaping. I also pay tribute to my colleague Caroline Johnson who highlighted this issue.

That’s why today, as part of work on stopping people starting smoking and vaping, we are opening a specific call for evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products - and explore where the government can go further. We will look at where we can go beyond what the EU’s Tobacco Products Directive allowed us to.

This will explore a range of issues including how we ensure regulatory compliance, look at the appearance and characteristics of vapes, about their marketing and promotion of vapes, and the role of social media, which is crucial. It will also seek to better understand the vape market, looking at issues such as the price of low cost products and disposables.

We are also working closely with colleagues at the Department for Environment, Food and Rural Affairs (Defra) to consider the environmental impact of vapes - particularly disposable vapes which have become so appealing to young people. In 2022, 52% of young people who vaped were using disposable products, compared to just 8% in 2021.

Over 1.3 million disposable vapes are thrown away each week. This accumulates to 10 tonnes of lithium a year, equivalent to the lithium batteries of a staggering 1,200 electric vehicles.

The call for evidence will be open for the next 8 weeks.

We hope that everyone concerned will take this opportunity to share their views to help shape our future approach, particularly for our young people.

We are already taking action to enforce the current rules.

I was extremely concerned to hear of certain disposable vaping products that do not adhere to our regulatory standards. There has been a particular issue about the Chinese-made Elf Bar.

Working closely with the Medicines and Healthcare products Regulatory Agency (MHRA) and Trading Standards we have agreed a voluntary withdrawal of some of these products from the UK market. Some large supermarkets like Tesco are setting a good example by working across their distribution network and ensuring all their products meet the requirements.

I urge the rest of the retail sector and vape manufacturers to follow suit and to follow our vaping product rules. If they do not do this, it could result in an unlimited fine. Companies failing to comply with the law will be held accountable.

To that end today I can announce that we will go further to enforce the rules.

Working hand in glove with our enforcement agencies and learning from our work with Trading Standards on illicit tobacco, we will provide £3 million of new funding to create a specialised ‘flying squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

This national programme will help share knowledge and intelligence across regional networks - including on organised crime gangs.

It will bolster training and enforcement capacity in Trading Standards and undertake specific projects such as test purchasing in convenience stores and vape shops. We will produce guidance to help build regulatory compliance. We will remove illegal products from shelves and at our borders, and we will undertake more testing to ensure compliance with our rules.

But while we want to make sure children don’t take up vaping, vaping can play an important role in helping the government achieve its smokefree 2030 ambition.

Vaping is effectively a double-edged sword. On the one hand, we do not want children to develop an addiction to any substance at a young age.

But on the other hand, for adults, vaping is substantially less harmful than smoking and we now have high-quality evidence from Oxford University that compared to nicotine gum or patches, vapes are significantly more effective as a quit tool, but not more hazardous.

This is particularly true when they are combined with additional behavioural support from local stop-smoking services.

Vaping is already estimated to contribute to about 50,000 to 70,000 additional smoking quits per year in England.

However, vapes are not yet being used widely enough to reach their full potential as smoking quit aids, showing the potential power of it as a tool.

A ‘swap to stop’ partnership is a scheme where smokers are provided with a vape starter kit alongside behavioural support to help them completely stop smoking.

There have already been successful local pilots of ‘swap to stop’ schemes in many areas, such as in Bath, Southampton, Sheffield and Plymouth.

Learning from these proven effective pilots, today, I am delighted to announce that we will be funding a new national ‘swap to stop’ scheme - the first of its kind in the world.

We will work with councils and others to offer a million smokers across England a free vaping starter kit. Smokers who join this scheme, which will run initially over the next 2 years, must join on one condition – they commit to quit smoking with support. For our part we will make it as easy as possible, referring people to stop-smoking services and developing a digital approach to help people quit smoking. Once that is done, we will offer support to those who want to go on to quit vaping, too.

We will target the most at-risk communities first - focusing on settings such as job centres, homeless centres and social housing providers. And we want to work with retailers on this journey, too.

Among the first of these exciting projects will be in the North East. I have already been working with local councils in Northumberland, Gateshead, South Tyneside and Hartlepool to start a joined-up delivery of a ‘swap to stop’ scheme in their most deprived neighbourhoods.

This scheme represents an exciting opportunity to capitalise on the potential of vaping as a tool to help smokers quit.

The latest international research shows that smokers who use a vape every day are 3 times more likely to quit smoking, interestingly, even if they didn’t actually intend to quit smoking.

So we will offer a million smokers new help to quit.

Let me now turn to other steps we will take to stop smoking and start quitting.

And let me start with our next steps to tackle illicit and underage sales.

Taking action against those who break the rules, firstly, protects legitimate shops from being undercut.

But we also know that this is very important to stop underage people starting smoking, because illicit tobacco and underage sales are strongly linked.

We’ve already implemented a successful new UK-wide system of track and trace for cigarettes and hand-rolling tobacco to deter illicit sales.

This system requires all cigarettes and hand-rolling tobacco to be tracked right from the manufacturer to the first retailer using unique ID codes applied to the products.

Track and trace will be extended to all tobacco products in May 2024. This means not only will we track cigarettes and hand rolling tobacco but also cigars, cigarillos, shisha and other tobacco.

Operation CeCe, a UK-wide intelligence hub between HMRC and National Trading Standards, has also bolstered our efforts against illicit tobacco, and we have given it long-term funding.

Operation CeCe resulted in more than £7 million worth of illegal tobacco products being removed from sale in its first year, and prevented far more illegal activity.

HMRC are also introducing tougher additional sanctions to track and trace to deter repeat offending, including a new civil penalty of up to £10,000 for more serious offences.

I can also announce that this year, HMRC and Border Force will be publishing an updated strategy to tackle illicit tobacco.

It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.

If you supply tobacco for sale in the UK you must be registered for Tobacco Track and Trace and also obtain an economic operator ID.

We want to start using this existing system in a new way - to help strengthen enforcement and target the illicit market.

From now on where people are found selling illicit tobacco, we will seize their products, we will remove their economic operator ID and they will no longer be able to buy or sell tobacco.

We are also exploring how to share information with local partners about who is registered on the track and trace system, so they know who is and who isn’t legally entitled to sell tobacco in their local areas, helping to drive enforcement.

Now of course some would go further - to stop people to start smoking in the first place. The Khan Review last year advocated the New Zealand approach - a full phase out of smoking, with the age of sale increasing over time to cover all adults.

This would be a major departure from the policy pursued over recent decades which has emphasised personal responsibility and help for people to quit. And it is the help for current smokers to quit that we want to focus on.

And, there is much more we can do to help people quit smoking.

Over half of all smokers - that’s 3 million people - want to quit smoking. One million of these people want to quit in the next 3 months.

But nicotine is highly addictive. We know that 95% of unsupported quit attempts relapse within a year.

So we will do more to help people quit.

First, we will use the latest treatments - proven to give smokers a much greater chance of quitting.

Some of the most cost-effective treatments that we have are not currently available in England. We are working closely with suppliers to give access to prescribers, to put licensed medications in the hands of those who would benefit the most from them. For example, ensuring the availability of proven smoking cessation medicines such as Varenicline and Cytisine. We have been working urgently with business to unblock supply chain problems to support more people who want to quit.

Second, we’ll join up services through the new integrated care systems, to make the NHS more like a national prevention service.

The pioneering work being done by the Humber and North Yorkshire integrated care board ( ICB ) - is leading the way in devoting local health service resources, organising the local system to have a local voice in driving down smoking rates in their most deprived communities. In April - this month - they will ‘go live’ with their comprehensive tobacco control programme. They will go first in implementing many of our national plans, including the provision of incentives for pregnant women to stop smoking, providing vapes as a first-line quit aid in local stop smoking services, lung health screening and joining up local services to tackle illicit tobacco.

I encourage all other ICBs to follow their example and develop similar partnerships with local authorities to create effective tobacco control programs. This is a really good example of integrated care systems working together to drive prevention.

Third, we’ll help pregnant women quit. Nationally, 9% of women still smoke in pregnancy - but it affects as many as nearly 1 in 4 births in some areas. Of course smoking in pregnancy increases the risk of stillbirth, miscarriage and sudden infant death.

All maternity services in England are establishing pathways to ensure rapid access to stop-smoking support for all pregnant women. We’ve already rolled out carbon monoxide testing widely to mothers.

Recently financial incentive schemes have been proven effective to increase the number of pregnant women successfully quitting. In trials, women receiving financial incentives are more than twice as likely to quit. The return on investment for these schemes is £4 for every £1 invested.

These schemes have been effective in a number of local areas, including Greater Manchester, which has seen the biggest drop in maternal smoking rates over the last 2 years.

So today we build on that local evidence and I’m announcing that we will offer a financial incentive scheme to all pregnant women who smoke by the end of next year.

This will unlock a lifetime of benefits for the child and the mother.

Fourth, we will provide further help for people with mental health conditions to quit.

Smoking is more than twice as high in people living with mental health issues. They will die 10 to 20 years earlier, and the biggest factor in this is smoking.

It is a common misconception that smoking helps anxiety. Actually smoking exacerbates anxiety and depression. Quitting smoking has been proven to be as effective as taking anti-depressants.

So we will work with mental health services to improve the signposting to evidence-based support for smokers. At a minimum, all mental health practitioners will be able to provide signposting to specially developed, evidence-based, digital quit resources.

Fifth, to help people quit, we will use a new approach to health warnings.

The front of cigarette packs has contained ‘smoking kills’ warnings since 1991. We will continue this, but we also want to give people hope and connect them in a hassle-free way to the best offer of support.

We will consult this year on introducing mandatory cigarette pack inserts with positive messages and information to help people quit. In Canada, health-promoting inserts are required by law and have been in place since 2000. Evidence from the experience in Canada shows pack inserts are an effective measure to increase the number of people attempting to quit smoking.

We have commissioned the University of Stirling to undertake testing with UK adult smokers and young people to help get this right.

We are exploring how best we can use innovative approaches within this, such as the use of QR codes to make it as easy as possible for people to get help to quit. You could take a pic with your phone and be taken straight to stop-smoking support, the kind I’ve been talking about in this speech.

In conclusion, the evidence is overwhelming that stopping smoking not only has major health and economic benefits, it is crucial to extending healthy life expectancy, particularly levelling up the places it is lowest.

That’s why today we are:

• stopping the growth of vaping among children
• introducing new help for a million smokers to quit
• increasing enforcement of illicit sales
• expanding access to new treatments
• backing joined-up, integrated approaches
• rolling out a national incentive scheme to help pregnant women quit
• consulting on new pack inserts using modern technology

All these are ways we will help people quit.

These proposals to reach our goal of a smokefree 2030 are some of the most innovative in the world.

They will give more people the help that they need to quit smoking for good.

So thank you to all of the experts in the room today that have fed in ideas to inform the speech today – and I look forward to your questions.

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The great vape debate: are e-cigarettes saving smokers or creating new addicts?

The US is cracking down on vaping while the UK is promoting e-cigarettes as an aid to giving up smoking. Where does the truth lie? By Sarah Boseley

G one With the Smoke is already no more than a distant whiff of bubblegum-flavoured vapour. The vape shop and lounge, one of many in San Francisco, has been forced to close. So have Vapor Den (“eclectic lounge & hipster go-to”) and Happy Vape. From late January, it became illegal to sell e-cigarettes and e-liquids in San Francisco. Even online sales to addresses within the city limits have been stopped. Stores outside the city that dispatch e-cigarettes to an SF postcode will face prosecution.

While vaping is banned, sales of legal marijuana and tobacco will continue as usual. San Francisco has often been considered more progressive than the rest of the US in its approach to drugs and unorthodox lifestyles: marijuana was legalised in California for medical use in 1996, after a campaign by Aids activists from the city, and for recreational use in 2016. Vaping , on the other hand, has crossed a line.

Behind the outright ban on sales of e-cigarettes in San Francisco is a panic about teenagers vaping. More than one in four American teens have tried vaping, according to the US Centers for Disease Control and Prevention. A study published in the New England Journal of Medicine reported that 12% of 16- and 17-year-olds were addicted to nicotine, and raised the alarm about the effect of nicotine on the adolescent brain. The Food and Drug Administration (FDA) recently described the use of e-cigarettes as a “crisis among America’s youth”.

“San Francisco has never been afraid to lead. That will always be the case when the health of our children is on the line,” announced the San Francisco city attorney Dennis Herrera in a statement after the ban was passed by the the city legislature last June. He was scathing about the FDA’s failure to control e-cigarette sales. “Now, youth vaping is an epidemic. If the federal government is not going to act to protect our kids, San Francisco will,” he said.

In the UK, meanwhile, the medical establishment is endorsing vaping as an aid to giving up smoking. My local vape shop in London is colourful, thriving, offers a panoply of flavours and displays a banner the length of its storefront proclaiming: “Vaping is 97% safer than smoking, according to NHS and Cancer Research UK.” (The correct figure is 95%, according to a report in August 2015 by Public Health England, PHE, the government executive agency and watchdog that offers guidelines on health protection issues.)

A transatlantic schism has opened up over vaping and health. In the US, the war on vaping is being pursued by activists, politicians and scientists who believe that tobacco companies are cynically promoting e-cigarettes as a means to get people addicted to nicotine, which will – sooner or later – lead them to cigarettes. In the UK, anti-smoking campaigners and health experts counter that for many adult smokers, vaping offers the best hope of avoiding a premature death.

The two sides periodically break into open hostilities. The claim by PHE that vaping is 95% safer than smoking tobacco, frequently quoted by e-cigarette manufacturers and sellers, has been criticised as misleading by anti-smoking campaigners in the US. Matt Myers, who heads the Campaign for Tobacco-Free Kids in Washington DC, the biggest anti-smoking organisation in the world, has called the 95%-safer figure “mere fiction”.

Prof Ann McNeill of King’s College London, a tobacco and addiction expert who advises PHE, defends its position. “We are battling against misinformation on a massive scale,” she says. McNeill acknowledges there has been a rise in vaping among kids in the US and Canada, but does not see it as a reason for panic. “I don’t think it merits discussion of an ‘epidemic’. That word is overblown,” she said.

The soaring popularity of vaping among the young in the US is largely down to Juul – a tiny black or chrome device that looks like a USB stick and fits into the palm of the hand. In 2004, two design graduate students came up with the idea for an electronic alternative to smoking. They launched Juul in 2015, which quickly defined the market; by July 2019, Juul accounted for 75% of US e-cigarette sales. Since then, its fortunes have taken a dive. The company is accused, in dozens of lawsuits from San Diego to New York City, of targeting young users via social media campaigns featuring youthful models. Opponents claim Juul pods are easier for novice vapers to inhale, since they contain nicotine salts instead of straight nicotine, further softened with teen-friendly flavourings such as mango, cool cucumber and creme brulee. Juul has repeatedly denied it has marketed to teens.

There was fresh alarm in the US last year when 2,500 cases of lung disease and 55 deaths were associated with vaping. E-cigarettes work by heating liquid containing nicotine to produce vapour, which is then inhaled. There is no smoke or tar involved, but there are small amounts of chemical flavourings, including diacetyl, which has been linked to lung disease, and propylene glycol or vegetable glycerin. If the e-liquid overheats, formaldehyde can be formed. In fact, none of these chemicals were to blame in these cases – it turned out that the people who fell ill were using bootleg devices containing cannabis – but the reputational damage was done.

In the wake of this alarming spate of hospitalisations and deaths, the New York state governor, Andrew Cuomo, took emergency action in September, attempting to ban flavoured e-cigarette products. President Trump entered the fray , telling the FDA to act and imposing a temporary ban on any flavours that might appeal to young people. In December, New York City mayor, Bill de Blasio, signed a law banning flavours. “Manufacturers of fruit and candy-flavoured e-cigarettes are intentionally and recklessly targeting young people,” said Cuomo, citing flavours including bubblegum, cotton candy and Captain Crunch. The state ban was overturned in January 2020 by Justice Catherine Cholakis, who said it was an overreach.

In the UK, the NHS continues to edge as close as it can to approving the use of e-cigarettes to quit smoking. NHS hospitals in the West Midlands have sanctioned vape stores on the premises , while PHE launched, via YouTube, a video showing two white-coated experts with bell jars demonstrating how e-cigarettes are free of all the disgusting and damaging tar in a conventional cigarette.

The science is furiously disputed. Academics on both sides are accused of cherry-picking data to suit their own prejudices. PHE is a global authority on health issues such as vaccination and obesity, but on vaping, it is looking increasingly isolated. Deborah Arnott, head of Action on Smoking and Health (Ash) in the UK, says that Britain is losing ground in the e-cigarette debate because of the virulent campaign in the US against vaping. “The noise is causing problems in how we are perceived,” Arnott said. “We’re being written off.”

W hat should be settled by science has become a clash of faiths. In the US, the debate is dominated by those who believe people should “just say no” to drugs. In the UK, there is more support for the idea of “harm reduction”, in which addicts take controlled amounts of their drug, be it alcohol, heroin or in this case, nicotine, to keep them stable.

PHE’s support for e-cigarettes as a tool to help people quit smoking is shared by other respected health bodies, such as the Royal College of Physicians and Cancer Research UK. They point out that the UK regulates smoking and vaping far more rigorously than the US. The UK has rules on age, and health warnings, and caps on the nicotine content. Marketing to young people is forbidden – e-cigarettes cannot be advertised on TV. There is less nicotine in Juul pods or e-cigarette cartridges sold in the UK: Juul in the US contains up to 59mg per ml, while nicotine levels in e-cigarettes across Europe are capped at 20mg per ml by an EU directive enshrined in British law. In the US, at this point, there is no middle ground between unrestricted sales and an outright ban.

All sides agree that vaping nicotine is safer than getting it from cigarettes. Nicotine by itself is “relatively harmless”, according to the NHS , while the harm from cigarettes is in the smoke produced by burning tobacco and the residue of tar it leaves, which damages the airways, causing lung disease and cancer.

“People smoke for nicotine but they die from the tar,” wrote Michael Russell, a professor in addiction at the Institute of Psychiatry in London and a pioneer of harm reduction, in 1976. His work laid the foundations for the introduction of nicotine replacement therapy – the nicotine patches and gum the NHS hands out today.

Russell, who died in 2009, wanted to develop a low-tar cigarette that would be high in nicotine, to give smokers the hit they wanted without inhaling more deeply. His research on the low tar product was funded by the tobacco company RJ Reynolds, now owned by British American Tobacco (BAT). This relationship with a tobacco company, which Russell later claimed was normal practice at the time, is now seen as fatally compromising. It has since been used to undermine his research and attack his reputation.

Ann McNeill, who worked with Russell as a young researcher, believes he was ahead of his time. “His pioneering research improved the quality of life of smokers and saved the lives of many more,” she said in a paper celebrating Russell, co-written with Debbie Robson of the UK Centre for Tobacco & Alcohol Studies. “It is a sad indictment of our community that his work is still not recognised adequately by all those working in tobacco control, some of whom still fail to recognise the centrality of nicotine in tobacco use and the implications of this.”

Anti-tobacco activists – whether they are for or against e-cigarettes – believe they are defending the gains they have made in the battle against smoking. Vaping’s defenders say the tobacco firms are diversifying into a product that won’t kill their customer base. Hardline opponents are convinced e-cigarette sales will keep the hated tobacco companies in business.

The major tobacco companies – Philip Morris, Imperial, British American Tobacco and Japan Tobacco – did not take long to realise the potential of e-cigarettes, and all are now players in the vaping business. Blu, launched in the US in 2009 by an Australian entrepreneur, was bought by Lorillard Tobacco, and later acquired by the British company Imperial. In 2013, BAT launched Vype. In 2015, RJ Reynolds, makers of Camel and Lucky Strike, produced Vuse, which was the most popular brand in the US before Juul came along. Altria, the parent company of Philip Morris USA, acquired a 35% stake in Juul.

Most scientists and health campaigners in the US will have no dealings with the tobacco industry, because of its history of devious marketing practices and underhand tactics. Under the terms of a World Health Organization (WHO) treaty in the early 00s, governments agree not to have any discussions with tobacco industry representatives (over trade terms, for example, taxation, regulation or investment). But anti-smoking campaigners now fear that, by promoting the benefit of their e-cigarettes as an alternative to smoking, tobacco companies are acquiring respectability. WHO shares that anxiety and has advised measures to control e-cigarettes. Many countries, including Brazil, Thailand, Singapore, the Seychelles and Uruguay, have banned e-cigarettes as a result, while others have imposed regulations limiting their use.

A number of health professionals and academics have dedicated their careers to exposing lies about the safety of tobacco products and stopping the promotion of cigarettes around the world. Recent hard-won victories include smoking bans in public spaces and plain packaging with severe health warnings. Despite their efforts, there are still over 1 billion smokers in the world. The global cigarette market was worth $888bn (£682bn) in 2018 and forecast to rise to $1,124bn by 2024.

Stanton Glantz, professor of medicine at the Center for Tobacco Control, Research and Education at the University of California San Francisco, is the loudest of the anti-tobacco lobbyists – in his choice of Hawaiian shirts as well as his pronouncements. Glantz claims he was agnostic when e-cigarettes first appeared. He isn’t now. In December, he tweeted : “Using e-cigs increases exposure to toxic chemicals for most users; they would be better off just smoking.”

This was a new extreme, even for Glantz. Alex Berezow, vice-president of scientific affairs at the American Council on Science and Health, described the tweet as “mind-boggling”. “Unfortunately, Dr Glantz has become something of an ideologue. His (justifiable) animosity toward the tobacco industry has been turned (unjustifiably) to other industries, such as vaping,” he wrote on his blog. The research paper that had prompted Glantz’s tweet, Berezow pointed out, actually shows that e-cigarette users get less exposure to toxic chemicals than tobacco smokers – not more.

Glantz, who you have to interrupt if you want to ask a question, told me that in the tweet, he was talking about dual-users – people who are both smoking and vaping. “Maybe it was worded inarticulately,” he conceded. But he won’t back down. He claims the evidence suggests that most people are dual users (in the UK, about a third of vapers are still smoking as well, according to a survey by YouGov).

A giant in the anti-tobacco lobby, Glantz does not understand how researchers he respects can support vaping. Glantz claims that confidence in e-cigarettes, at PHE and among the UK scientists who condone it, is starting to crack. He is convinced the “95% safer” figure is wrong. It came from a paper published in 2014 by a group of experts led by David Nutt – the former government drugs adviser famous in the UK for declaring that ecstasy and LSD were safer than alcohol, which led to his sacking.

“The Nutt paper had no evidence whatsoever. It was 12 guys who sat around and pulled that number out of the air,” said Glantz. “The most generous thing you can say about that paper is that it was much earlier in the process and there wasn’t a lot of evidence out there.” He believes the credibility of Nutt’s group has been undermined by revelations that they were part-funded by a consultancy called EuroSwiss Health, run by Delon Human, a South African doctor who has accepted funding from BAT for some of his ventures.

Nutt says that’s nonsense. The group comprised 12 world experts. “Has [Glantz] ever read the paper?” he said. “There are 14 variables in that paper [possible harms, such as death from cancer]. It looks at the effect of 12 different forms of nicotine on 14 variables. And I bet he wouldn’t actually disagree with any of them.” He gives an example. “Does he actually think that tobacco is not much more harmful than vaping on the likelihood of lung cancer?” The paper, he said, “comes up with an answer he doesn’t want. That’s why he thinks it’s bad science.”

Nutt, a professor in neuropsychopharmacology at Imperial College London, says he is “saddened” by Glantz’s attacks. “He was a hero of mine. He was one of the pioneers in demolishing the myth that tobacco wasn’t addictive and opposing the fraud and misinformation and lies of the tobacco industry. But the problem is he is still basically playing the same tune and we’re now in a different era.” It’s proven impossible to stop people selling tobacco, Nutt said. “So the anti-tobacco people have got to attack something else, because that’s what they do – they attack and they ban. So basically they’ve fixed their wagons against vaping because it is one thing they can ban, and they’re very successful. It’s laughable that in India people go to prison for selling vaping when the government allows advertising of tobacco.”

Glantz became an icon of the anti-tobacco movement after he received 4,000 leaked documents from Brown and Williamson, then the US’s third-biggest tobacco company, in 1994. They proved the industry knew that smoking caused cancer and had hidden it. Since then, Glantz has always objected vigorously to any compromise with the industry. In 1997, a deal was broached with the tobacco industry by Matt Myers of the Campaign for Tobacco-Free Kids. It would have brought in tight federal regulatory control of cigarettes, prohibiting the sort of advertising and marketing that is still ubiquitous in the US, as well as sales to children. But Glantz was opposed to any deal that would allow cigarette manufacturers to continue in business. His goal was to close them down altogether. Myers was stymied by his own allies, and the US still does not have the anti-tobacco regulations that are common in Europe.

Myers is calm and quietly authoritative. He is not against harm reduction, he says. Nor are other public health bodies such as the American Cancer Society or the American Heart Association. “All of us have said that under appropriate circumstances, if e-cigarettes are shown to actually significantly help smokers quit or switch completely, and that there are rules in place to prevent them being marketed in a way that doesn’t unduly impact youth, we would be supportive,” he said.

Up until now, on a national level, the US has had no regulatory control of e-cigarette sales, marketing, minimum age, or limits on nicotine content. “It’s the wild west,” said Myers. Tobacco-Free Kids has brought legal action against the FDA over its failure to regulate e-cigarette use and last year won a ruling from a federal judge that there was no excuse for further delay. The e-cigarette companies are irresponsible too, Myers added.

Myers says both sides in the argument interpret scientific studies according to their prior beliefs. He describes PHE’s “95% safer” figure as worthless, because not enough research has been done. “I have very little doubt that e-cigarettes under appropriate circumstances are significantly less harmful to a smoker. Do we know exactly how much less harmful? The answer is no, because we have no clue how much nicotine it is delivering, how pure they are, what else they’re putting in them. Comparing it to the most lethal product ever created, for public relations purposes, is not helpful.”

I n March 2018, Myers and Glantz, as well as representatives of PHE and almost every other influential anti-smoking scientist or campaigner, attended the World Conference on Tobacco or Health in Cape Town – just up the road from BAT’s South Africa HQ. At this meeting, held every two years, activists can discuss the perfidy of the industry, celebrate their successes and plan for the future.

Nobody connected with the tobacco industry is allowed in the building. The WHO’s Framework Convention for Tobacco Control, which came into force in 2005, lays down recommended anti-smoking measures for governments, from taxing cigarettes to marketing controls and smoking bans in enclosed public places. It has been signed by 168 countries (the US is a notable exception). The Framework document says governments “need to be alert to any efforts by the tobacco industry to undermine or subvert tobacco control efforts” and must limit their contact to the absolute minimum. Activists now take this to mean there must be an impenetrable wall between themselves and anyone in any way connected with tobacco.

The man who did as much as anyone to establish the Framework Convention while an executive director of WHO, Derek Yach – originally from Cape Town but now based in the US – finds himself on the wrong side of that wall. Yach was pointedly excluded from the conference in his home city – and yet much of the conversation was about him. Yach had done the unthinkable: accepting almost $1bn over 12 years from Philip Morris, makers of Marlboro and other leading brands, to set up his Foundation for a Smokefree World in New York in 2017 to fund research into alternatives to tobacco.

As part of its commitment to a “smokefree future”, Philip Morris International is heavily promoting its e-cigarettes and Iqos, a cigar-shaped electronic device designed to heat, rather than burn, tobacco. “These products will one day replace cigarettes,” it says on its website, claiming to be moving on from tobacco products because “society expects us to act responsibly”. Iqos has taken off in Japan, where 3 million people regularly use them. Smoking there was declining by 2% a year before Iqos arrived, and is now dropping by 10% per year, for which Philip Morris International claims the credit.

Yach believes it’s in the tobacco companies’ interests to develop products that will leave conventional cigarettes behind. His erstwhile colleagues believe he is working for the devil. Why, they ask, does Philip Morris still sell cigarettes if it cares about the world’s health?

As rumours circulated that Yach was in the building or lurking outside, Michael Bloomberg, the billionaire former mayor of New York and funder of vast amounts of anti-tobacco science and programmes, was launching his own campaign. Striding down the hallway, flanked by purple banners emblazoned with the words Bloomberg Philanthropies, the financial backer of the conference and his entourage made their way to the TV cameras to discuss his Stop initiative. Bloomberg announced he has set aside $20m to counter the lies of the tobacco industry. Top of the watch list was Yach’s Foundation.

Bloomberg helps pay for WHO’s work on tobacco. I was offered a five-minute audience – just long enough to ask if he thinks there’s a role for e-cigarettes in combating smoking. “It is like marijuana: one of the stupid things we’re doing is legalising it,” he said. “I think there’s no place for e-cigarettes. I think it’s a terrible idea.”

Yach claims that “A-grade scientists and researchers around the world” are picking up grants from his foundation and doing useful work, but few believe he can succeed. He admits he was taken aback by the strength of feeling. “I wasn’t completely naive about it, but I didn’t actually appreciate how harsh it would be, particularly from a pretty small bunch of people who have incredible influence at WHO,” he says.

Clive Bates, the former head of the UK’s Ash, who blogs and campaigns for e-cigarettes from his home in Nigeria – he is married to the British High Commissioner – said he was amazed by the anti-vaping anger in Cape Town. “It was like a cult, almost,” he said. “Particularly the attacks on the foundation. It’s quite an achievement for Derek to create an institution that has a worse reputation than Philip Morris.”

However, Robert West, a professor of health psychology and director of tobacco studies at UCL, says: “It is playing out beautifully [for Philip Morris]. [The Foundation] has got the tobacco control community arguing among itself and divided. Result.”

I n the UK, a small number of prominent public health academics vehemently oppose e-cigarettes. Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, and Simon Capewell, professor of clinical epidemiology at Liverpool, believe the tobacco companies are using e-cigarettes as a route back to respectability. Sally Davies, until recently the UK’s chief medical officer (the most senior government adviser on public health matters), backs a ban on flavours that might attract children. She’s worried that we don’t know the long-term health effects of vaping, which she described as a “ticking time bomb”.

Ann McNeill says there is not much growth in vaping among kids in the UK. Her key concern would be a rise in vaping among young people who have never smoked, but there’s no sign of that. She thinks the key to reducing youth uptake is “getting adult smoking down”, because young people tend to imitate their elders’ behaviour.

She feels she and her colleagues at PHE have been unfairly attacked for saying vaping is 95% safer than smoking tobacco. She points out that they never said it was harmless . A 5% risk of harm, she insisted, “is not an insubstantial number”. She feels that the statement has been twisted as if PHE had said vaping was completely safe.

There is evidence that smoking is going down as e-cigarette use goes up, both in the UK and in the US. In 1942, 82% of British men smoked. By 2006, when e-cigarettes first appeared, 22% of adults in England smoked. The number of smokers is now at an all-time low of 14.7%, while 7% of the UK population are vaping regularly. Bans on smoking in public places, no-logo cigarette packaging with gruesome pictures of tumours, and the removal of cigarettes from sight in shops have all had an impact, but, McNeill says: “All the evidence, I believe, points to e-cigarettes playing a role.”

The best evidence that vaping helps people stop smoking comes from a study showing that e-cigarettes double the quitting success rate compared to gum or other aids. Peter Hajek from Queen Mary University of London and colleagues carried out the trial among more than 880 people who went to the NHS for help to give up smoking. Half were given nicotine replacement therapy in whatever form they wanted, such as patches or gum. The other half were given a starter e-cigarette kit and encouraged to buy their own when it ran out. The results, published in the New England Journal of Medicine in January 2019, showed that, at a year, the quit rate in the e-cigarette group was twice that of the nicotine replacement group, 18% versus 9.9%.

Of course, it did not satisfy the critics. When the researchers went back to the subjects after a year, most of the e-cigarette group were still vaping, whereas few of the ex-smokers in the other group were still chewing gum. So, they insisted, the study showed just how addictive e-cigarettes are.

Juul, once the leading e-cigarette, is struggling against public outrage and bad press. Sales have dropped and hundreds of staff have been laid off. The company said to be worth $38bn in 2018 was written down to $24bn by Altria in October last year, and valued at just $19bn by one of its major investors, Tiger Global Management, in December.

In the storm over child users, and anticipating an FDA ban, Juul stopped selling its fruit medley and mango flavours in the US in October and even dropped mint the following month. In January, the FDA acted, banning all flavours except tobacco and menthol from e-cigarettes that use a cartridge – as the Juul devices do. These are the devices kids use, said the FDA: flavours will not be banned from the refillable e-cigarettes that are more popular with adults. The FDA is also finally getting going on regulation, and has instructed manufacturers of e-cigarettes to apply for a right to trade by May.

The WHO, taking its cue from the US and from Bloomberg, has advised countries to control vaping, warning about the unknown impact on health and stating that e-cigarettes are risky for teenage brains, as well as for the foetus. That may leave the UK isolated, a lone bastion where (highly regulated) vaping is actually encouraged in the hopes of cutting smoking rates. Many public health experts in the UK believe they are witnessing an unnecessary tragedy, and that failure to promote the most promising method of helping people quit smoking is endangering the lives of millions.

McNeill insists public health experts in the UK do care about young people. But those whose lives are at risk are adults living in disadvantaged communities, who cannot kick their smoking habit. “I have lived with smokers and watched smokers die. You want them to do anything they can to prevent them from smoking.”

This article was amended on 19 February 2020: to clarify that Altria is the parent company of Philip Morris USA and that Iqos is a product of Philip Morris International and to correct an error in attributing a quote from the WHO’s Framework Convention for Tobacco Control.

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Get Talking

You can play a significant role in protecting your child from the dangers of vaping and nicotine dependence, and maintain an open line of communication.

Email the Discussion Guide

Your conversation tips have been sent to the email address provided.

Based on your responses, the tips and suggestions below can be used as a framework for having a conversation with your child.

• Before You Talk
• After You Talk
• While You're Talking

Know the facts

Misinformation about vaping is everywhere. Two thirds of teens don’t even realize that e-cigarettes contain addictive nicotine.

Before the conversation, get comfortable with the key dangers and potential motivations for kids to vape. You may not feel like an expert, and that’s okay. Expressing care and concern is one of the best ways to support your child.

Check out our Get The Facts page.

Put yourself in your child’s shoes.

Consider your kid’s viewpoint. Imagine the obstacles, pressures and social environment before you address your concerns.

Remember what it was like when you were a kid. Make sure to relate to them. Remind them that you’re on their side. When empathy is expressed and good communication exists, kids take fewer risks.

Find the right time and place.

Wait for the right opportunity to increase the chance that you are heard. Maybe you’re passing a vape shop, watching TV together or talking before your child goes to a concert with friends.

Pick a calm moment that is distraction free. Asking your child about vaping when it is already top of the mind gives you a non-confrontational way to learn about your child’s awareness, interest and involvement without defensiveness.  

Take an open and calm approach.

As you talk to your child, avoid judgment or frustration. Kids may pick up on your tone and tune out or react defensively.

An open conversation will disarm the notion that this is a lecture. It will also provide a relaxed environment to discuss ideas without making them feel like they are being blamed or in trouble.   

Take time to practice.

For important and potentially difficult conversations like these, it’s helpful to know exactly what you’d like to say before you say it. Take time, in front of the mirror or with a partner, to run through the points that you feel are most important.

Consider how your child will react to the information. Try to anticipate how the conversation may go and come prepared to respond calmly to any situation. Use tips in this guide and our  Get The Facts page to help as you prepare.

Help your child manage stress.

Unfortunately, stress is universal and can be experienced at a young age.

Talk to your kid about any larger concerns or pressures they may be feeling. Make sure they have healthy outlets for relief. 

Help your child manage peer pressure.

One of the largest motivating factors of youth vaping is influence from friends or classmates.

Consider rehearsing or role playing to give your kid the social tools to refuse tobacco products. Offer some quick facts or an anecdote that they may feel comfortable sharing. For more information and advice on how to help kids handle peer pressure, explore this resource published by the University of Michigan.

This isn’t a one-time conversation. Even if everything goes well, over time there will be new curiosities, product developments and research findings. 

Make sure to leave lines of communication open. Fact sharing is a great way to reintroduce the conversation topic.

Say thank you.

Let your child know that you appreciate them for listening, for their honesty and for continuing to make the right decisions.

Ending the conversation on a note of trust will make it easier for them to talk to you when they have questions or need advice.   

Share this information.

There are other parents struggling with these same issues and how to address them. Share this website with them on social or in a quick email. The American Lung Association is also helping schools address the youth vaping epidemic with the Vape-Free Schools Initiative , which equips schools with resources and support for kids who are caught vaping on campus, and those that want to stop. Share the initiative with your child’s administrators and teachers.

Stay up to date.

Vaping is an ever-evolving issue. Keeping your child protected means staying informed. 

Sign up for our newsletter and refer back to our site as a trusted source for updates and trending new discussion topics.

Sign up for our vape-free e-alerts

Acknowledge your child’s independence.

Your children make good decisions every day. Abstaining from vaping could be one of them. 

Thank them for their responsibility and appeal to their good judgment. 

Ask for their perspective.

Hear their side of the story first. It’s good to know what they find appealing or unappealing about it. If they’re interested in trying it, ask why.

Ask them open-ended questions rather than yes or no questions. This will help them open up, be engaged and be less defensive.

Be ready to hear that your child may have vaped.

A much higher percentage of kids have tried vaping than most parents recognize. There is a distinct possibility that your child has experimented with vaping.

Make sure to start by thanking them for being honest. This is key for continuing an open conversation and relationship of trust. Explain that your motivation is protecting and caring for them. 

Avoid scare tactics.

It’s good to share your concerns, but don’t make the mistake of losing your child’s attention with dramatic claims. 

Equating vaping with other temptations or illegal drugs actually reduces your credibility and chances of connecting with them.   

Blame Big Tobacco, not your kid.

Your child is the target of Big Tobacco advertising, devised to intentionally hook a young audience on nicotine, and make them customers for life. The same companies who funded and promoted cancer-causing cigarettes are the same ones behind many vape products like JUUL. 

Remind your kid that you are both on the same side when it comes to Big Tobacco.   

Connect with what they care about.

Make their concern personal. Explain how vaping can prevent them from achieving their future goals. 

Use information from our Get the Facts page to point out how proven physical damage to lungs and brain will affect any athletic aspirations. Illustrate how vaping takes an invisible toll on mood, memory and attention span, impacting academic or career goals. 

Share your personal experience.

If you have experience with vaping or smoking cigarettes, consider sharing your story with your child and the challenges of nicotine dependence. 

Kids may be less inclined to vape if they have a personal connection to the negative effects of addiction.

Get Updates

Sign up to get important vaping-related resources. Especially now, due to the impact of smoking and vaping on COVID-19, the best way to protect your child is to be in the know.

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Home — Essay Samples — Nursing & Health — Smoking — Vaping: All You Need to Know about this Trend

Vaping: All You Need to Know About This Trend

• Categories: Smoking

About this sample

Words: 712 |

Published: Dec 18, 2018

Words: 712 | Pages: 2 | 4 min read

Table of contents

Vaping a fashion, vaping business, what’s the final point.

• House of Vapes
• Prohibition Vapes
• Vape & Juice
• The Wheatsheaf
• Prospect of Whitby

Hook Examples for Vaping Essay

• The Rise of Vapor: Step into the world of vaping and explore how this modern trend has taken the world by storm, reshaping the way people consume nicotine.
• Invisible Dangers: Uncover the hidden health risks lurking behind the enticing flavors and billowing clouds of vapor, as we delve into the alarming consequences of vaping.
• The Marketing Maze: Discover the strategies employed by vaping companies to target a new generation of users, and how the industry’s advertising tactics have raised ethical concerns.
• Teen Epidemic: Examine the startling rise in teenage vaping and the impact it has on adolescent health, education, and society as a whole.
• A Path to Quit: Explore the potential vaping holds as both a smoking cessation tool and a harm reduction method, considering the debates and challenges surrounding this approach.

Works Cited

• Cooper, R. (2018). Skipping a Beat: Assessing the state of gender equality in the Australian music industry. University of Sydney.
• Hibberd, J. (2020, March 8). How Women Are Changing the Indie Rock Scene. Rolling Stone.
• LISTEN. (n.d.). About. Retrieved from https://www.listenlistenlisten.org/about
• McMahon, K. (2019, April 29). The Triple J Gender Imbalance Is Being Highlighted Again By Industry Experts. Junkee.
• Merritt, S. (2019, October 3). Where are all the women in music production? Sydney Morning Herald.
• Music Industry Observer. (2021, January 25). How COVID-19 Has Impacted Women in the Music Industry. Music Industry Observer.
• O’Connor, R. (2018, March 8). International Women’s Day: Meet the women trying to change the face of the Australian music industry. ABC News.
• Rogers, K. (2018, November 21). An In-Depth Look at the State of Women in the Music Industry. Mixmag.
• Triscari, C. (2020, December 1). The music industry is finally waking up to its diversity problem. NME.
• UN Women. (2015). Gender Equality and the Music Industry. UN Women.

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VAPING PREVENTION & EDUCATION

Teach youth about the harms of vaping nicotine.

Browse science-based, standards-mapped classroom resources created by FDA's Center for Tobacco Products that aim to prevent vaping among middle and high school students. Choose from interactive quizzes, school-wide surveys, and creative advertising messages.

Lesson Plans

Find complete standards-mapped lesson plans for instruction in class or online, including student activities that are ready to share with evaluation guidelines. See fact-based print and download materials that educate students about the health risks of vaping.

Teens and Vaping: The Real Health Consequences

Vaping Research Project

Sizing Up E⁠-⁠Cigarette Marketing

The Risks of Vaping Magazine

Conversation starters: videos and blog posts.

Don't have time in your curriculum for a full lesson plan? FDA has produced short videos and informative blog posts about how to help teens understand the dangers of vaping nicotine.

My Vaping Mistake: Videos of Real Teen Experiences

Must-Know Facts About E⁠-⁠Cigarettes: Videos

How to Spot Stealth and Disposable E⁠-⁠Cigarettes

How to Discuss E⁠-⁠Cigarettes and Nicotine Addiction With Youth

Articles on Vaping

Displaying 1 - 20 of 113 articles.

Cannabis legalization has led to a boom in potent forms of the drug that present new hazards for adolescents

Ty Schepis , Texas State University

Pharmacists should be able to dispense nicotine vapes without a prescription. Here’s why

Coral Gartner , The University of Queensland ; Kathryn Steadman , The University of Queensland , and Lisa Nissen , The University of Queensland

Want to quit vaping? There’s an app for that

Fiona McKay , Deakin University and Matthew Dunn , Deakin University

We’ve taken smoking from ‘normal’ to ‘uncommon’ and we can do the same with vaping – here’s how

Carolyn Holbrook , Deakin University and Thomas Kehoe

Australia’s restrictive vaping and tobacco policies are fuelling a lucrative and dangerous black market

James Martin , Deakin University and David Bright , Deakin University

To stop teenagers vaping they need to see it as cringe, not cool

Emily Moorlock , Sheffield Hallam University

Could messages from social media influencers stop young people vaping? A look at the government’s new campaign

Michelle Jongenelis , The University of Melbourne

Nicotine pouches are being marketed to young people on social media. But are they safe, or even legal?

Becky Freeman , University of Sydney

Spice: the ‘zombie drug’ being found in some vape liquids

Michael Cole , Anglia Ruskin University

HILDA survey at a glance: 7 charts reveal we’re smoking less, taking more drugs and still binge drinking

Roger Wilkins , The University of Melbourne

For the new vape laws to succeed, these 3 things need to happen – or users may look to the illicit market

Wayne Hall , The University of Queensland

From today, new regulations make it harder to access vapes. Here’s what’s changing

Vape deals are everywhere this Christmas – here’s how to deal with the horrific waste problem

Andrew Turner , University of Plymouth

How much could the NHS save if people had healthier lifestyles? Hundreds of millions according to research

Francesco Moscone , Brunel University London

My teen is addicted to vaping. How can I help them quit and manage their withdrawal symptoms?

Gillian Sandra Gould , Southern Cross University ; Karen McFadyen , Southern Cross University , and Marilyn Clarke , Southern Cross University

Many people think cannabis smoke is harmless − a physician explains how that belief can put people at risk

Beth Cohen , University of California, San Francisco

What’s in vapes? Toxins, heavy metals, maybe radioactive polonium

Alexander Larcombe , Telethon Kids Institute

South Africa’s new vaping tax won’t deter young smokers

Nicole Vellios , University of Cape Town and Corne van Walbeek , University of Cape Town

‘The dirty disease’ – both smokers and non-smokers get lung cancer. They face stigma on top of illness

Jianni Tien , University of Sydney ; Alex Broom , University of Sydney ; Katherine Kenny , University of Sydney , and Malinda Itchins , University of Sydney

TikTok promotes vaping as a fun, safe and socially accepted pastime – and omits the harms

Renee Carey , Curtin University and Jonine Jancey , Curtin University

Related Topics

• E-cigarettes
• Public health
• Smoking cessation
• Teen vaping
• Tobacco control

Top contributors

Associate Professor, School of Public Health, University of Sydney

Emeritus Professor in Public Health, University of Sydney

Senior Adviser, The Daffodil Centre, University of Sydney

Director, NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland

Professor of Community Health and Health Behavior, University at Buffalo

Associate Professor of Social and Behavioral Sciences, Rutgers University

Assistant Professor in Health Promotion and Policy, UMass Amherst, UMass Amherst

Associate Professor, Melbourne Centre for Behaviour Change, The University of Melbourne

Professor of pediatrics, microbiology and immunology, and environmental sciences and engineering, University of North Carolina at Chapel Hill

Director of Tobacco Prevention and Evaluation, University of North Carolina at Chapel Hill

Research Fellow, The Daffodil Centre, University of Sydney

University Research Lecturer, Nuffield Department of Primary Care Health Sciences, University of Oxford

Senior Lecturer in Mental Health, University of East Anglia

Professor and Dean, School of Public Health, Georgia State University

Lecturer, School of Pharmacy, Queen's University Belfast

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