News, Population Health

Will the disposable vape ban save the NHS from another health epidemic?


As the government confirms its plans to ban the sale of disposable vapes, Sienne Amer examines the impact of vaping on the NHS so far, and to what extent the ban will help avert another health epidemic.

The UK government recently announced its plan to ban disposable vapes to protect children’s health and tackle the significant rise of vaping among young people. While we have not yet seen the full health impact of the younger generation using vapes, this ban may be a welcome first step in limiting the impact of what could have become the next health crisis.

The devices have appeared on the market recently and rapidly risen in popularity, which is why there is still little research available on the extent to which vaping harms our health. Introducing this ban has the potential to limit the impact vaping has on the NHS, which is already stretched responding to other health crises caused by tobacco smoking, alcohol abuse, obesity, and an ageing population.

There are 4.7 million people in Great Britain who use e-cigarettes, 31 per cent of whom are disposable vape users. Disposable vape brands are targeting children, using bright colours for packaging and a variety of interesting flavours, with the fruit flavours making them far more likely to appeal to children. A shocking 21 per cent of secondary school children have tried vaping and 57 per cent of disposable vape users are aged between 18 and 24. The most popular brand of disposable vapes, Elf Bars, were removed from supermarket shelves last year after the nicotine levels were found to be at least 50 per cent higher than the legal limit. The lack of regulation of these products is an issue, regardless of the effects of use.

Disposable vapes contain nicotine, and inflict similar impacts to any other nicotine product, including heart disease and other cardiovascular disorders, along with respiratory and gastrointestinal disorders. Children are especially susceptible to the toxicity of nicotine, which can impact brain development, leading to shorter attention spans, anxiety, depression and reduced cognitive function.

It has also been shown that when the coils in the e-cigarette are heated, toxic metals, including aluminium, chromium, iron, lead, manganese, nickel and tin leak into the e-liquid, which are then aerosolised, inhaled and absorbed by the lungs. E-liquids have been shown to contain ingredients that generate pulmonary irritants and carcinogenic carbonyl compounds, all of which can lead to respiratory, gastrointestinal, and constitutional symptoms, in addition to an increased risk of early onset strokes.

Although vaping is still recognised as a safer alternative to smoking by the NHS, there has not been sufficient investigation into the long-term impacts on health. Other countries, such as the United States, have recognised the impacts of vaping; in 2019, the US Center for Disease Control and Prevention announced an outbreak of e-cigarette/vaping product use-associated lung injury (EVALI) after it caused the deaths of several young people.

While there have not been any recorded e-cigarette related deaths reported in the UK, in 2023, the NHS recorded 420 vaping related hospital admissions, 15 of which were for children aged under 9, demonstrating the severe risk to health young children are exposed to.

When compared to just under half a million hospital admissions caused by cigarette smoking-related illnesses, the health impacts of disposable vapes appear to be minor. However, conventional cigarettes were only recognised as a significant health hazard in 1964, more than 40 years after the introduction of cigarette manufacture, showing the time it can take to fully understand the long-term effects a product can have on human health.

The NHS is already dealing with several other health epidemics, with smoking costing the NHS in England £2.6 billion per year, approximately 2 per cent of the NHS budget. Obesity costs around £6.5 billion a year and is the second biggest cause of preventable cancer. Alcohol abuse costs £3.2 billion a year in England. This is a total of £12.3 billion of the yearly NHS budget going towards preventable illnesses, and the cost of vaping would be an additional burden on NHS.

To what extent is vaping impacting the NHS?

At present, there is no record of the health-related costs associated with vaping. But modelling the cost to the NHS using smoking data could provide an estimation of the impacts vaping will have. The UK smoking population is equal to 6.4 million people, causing 474,000 hospital admissions a year at a cost of £2.6 billion. The model assumes that 7 per cent of the population requires hospital admissions, with each admission costing approximately £400.

The 420 admissions related to vape use last year would have cost the NHS approximately £168,000. However, vape-related hospital admissions only started to be recorded in 2019 and since then, there has been a 237 per cent increase in admissions. An annual growth of 10 per cent in the vaping population is also expected to cause an increase in admissions. This means that, if only 7 per cent of the vaping population is admitted, the cost to the NHS would be £132 million per year, excluding any impact of an uptake in the number of young people seeking mental health services as a result of the toxic effects of vaping.

The ban on disposable vapes is estimated to affect 2.6 million people in Great Britain – including 316,000 18-to-24-year-olds, who other than vaping, have never regularly used tobacco products – saving a large proportion of young people from the risks caused by nicotine dependence and vaping. As disposable vapes were initially introduced to the market as an alternative to cigarettes, there is a high risk that 75 per cent of people will revert to traditional tobacco products.

Since the focus of the ban is solely on disposable vapes, alternative e-cigarette products will continue to be available for people trying to quit smoking. It is crucial that information should continue to be collected and published, through platforms such as NHS Digital, to monitor and understand the health impacts of the current vaping generation, even post-ban. Hospitals should be advised to continue to use the ICD-10 code to improve data on vaping-related admissions, along with adjusting advisory information to support the disposable vape ban.

Sienne Amer is a Net Zero Graduate at Lexica.