Electronic cigarette use in young people in Great Britain 2015-2016.

The proliferation of electronic cigarettes (ECs) continues to divide public health opinion. Among the leading controversies are the risks to the individual user and the risks to youth. The exact risk reduction to smokers using EC is unknown. Although contested, Public Health England (PHE) and the Royal College of Physicians estimated that the relative harm from EC is around 5% of that from combustible cigarettes. Risks to youth have been identified by the World Health Organisation if EC act as a gateway to a) nicotine initiation and/or b) smoking via switching from EC. The gateway hypothesis is ill defined and the use of the term varies; additionally, progression from one drug or drug delivery system to another cannot imply causality given other competing explanations such as common liability. In relation to EC and smoking, non-use of any nicotine product is preferable, but given the relative risks of the products, it would be less harmful for a young person to use EC than smoke. Concerns would be justified, however, if the proportion of young people regularly smoking started to increase.