One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.

As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to five per cent or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.

In a speech on April 11, 2023, Health Minister Neil O’Brien also announced that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.

The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.

Additionally, there will be a crackdown on illicit vape sales to stop children and non-smokers from taking up the habit – which is growing in popularity among young people.

Neil O’Brien, the health minister said, “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.

“We will offer a million smokers new help to quit. 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.”

The new policies will deliver the government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.

For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.

Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.

Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.

NHS figures for 2021 showed that nine per cent of 11 to 15-year-old children used e-cigarettes, up from six per cent in 2018.

In recognition of the sharp increase, Neil has launched a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.

Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

As part of the measures, HMRC and Border Force will also be publishing an updated strategy in 2023 to tackle illicit tobacco.

Smoking prevalence in England in 2021 was 13 per cent - the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services.

In 2021-22, £68 million of public health grant funding was spent on stop smoking services by local authorities, and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

However, 5.4 million people in England smoke tobacco, which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking, and recent data shows one in four deaths from all cancers were estimated to be from smoking.

Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures.

Deborah Arnott, chief executive of Action on Smoking and Health (ASH), said, “In 2019 the government committed to making England smokefree by 2030, but it took four years for a public health minister to secure concrete action to deliver. Vapes increase smokers chances of successfully quitting, as do vouchers for pregnant smokers so these are welcome steps in the right direction, but they are nowhere near sufficient.”

“Last year’s Khan report, commissioned by government, warned that without immediate and sustained action the smokefree 2030 target would be missed by years. Not enough has changed, so that is still the case. Khan’s comprehensive strategy required funding of £125 million a year, many times more than the current announcements. Funding that’s desperately needed to reinstate cuts of more than 90 per cent to mass media campaigns, and nearly a half to smoking cessation services and wider tobacco control. Not to mention the absence of the tougher regulations Khan recommended to raise the age of sale, and reduce the appeal of smoking as well as vaping.”

Sue Mountain, a former smoker from South Tyneside, who quit smoking after treatment for laryngeal cancer said, “Tackling underage vaping is important and more regulation is clearly needed, but smoking is still the biggest risk to our children and action is needed there too. Hundreds of children a day start smoking and risk a lifelong addiction which will kill up to two thirds of long-term smokers.”

“Smoking killed nearly eight million people in the UK in the last 50 years and continues to kill tens of thousands every year. Without a comprehensive and well-funded strategy there’s no way the government will achieve its smokefree 2030 ambition. Tobacco companies are making massive profits from an addiction that robs people of their lives and their health. Big tobacco needs to pay for the damage it does – the government should make the companies fund more support for smokers and awareness campaigns discouraging children from starting and motivating smokers to stop.”

Professor Linda Bauld, director of the Spectrum Research Consortium and co-chair of the Smoking in Pregnancy Challenge Group said, “We welcome the Government’s commitment to introduce financial incentives to support more pregnant women to quit smoking. Incentives more than double the odds of women quitting during pregnancy, protecting babies from exposure to potentially deadly chemicals like carbon monoxide.”

“Incentive schemes have been successfully rolled out in places like Greater Manchester and are highly cost effective, with a return on investment of £4 for every £1 spent. A national scheme will reduce the burden on the NHS and help to get us on track to deliver a smokefree start for every child by 2030. “

Dr Clea Harmer, chief executive of sands and co-chair of the Smoking in Pregnancy Challenge Group said, “It’s great to see the government announce more support to help pregnant women quit smoking. Incentives during pregnancy will save babies’ lives and ease the financial burden on families in some of the most deprived parts of the country.”

“As well as being a leading cause of stillbirth and miscarriage, smoking traps families in a vicious cycle of poverty and addiction. The average smoker spends around £2,500 on tobacco every year to maintain their addiction, and one million children in England grow up in households living in poverty once the cost of smoking is included.”

“Every baby deserves a smokefree start in life and financial incentives will go a long way towards achieving this goal.”

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