While the US is still on the fence about Vaping, UK's Royal College of Physicians Endorses E-Cigarettes This week saw some big news for vaping: the Royal College of Phycians (RCP) released a 200 page report strongly endorsing e-cigarettes. Founded in 1518, the RCP is England's oldest medical college. Their unbiased report, titled Nicotine without smoke: Tobacco harm reduction, may prove to be hugely influential in creating policies regarding e-cigarettes in the UK. Due to its comprehensive analysis of the science and public policy surrounding e-cigarettes, the disapproval of several damaging myths associated with vaping, as well as the emphasis on the low risks associated with vaping, the report could have a positive impact on advancing the case of e-cigarettes well beyond the borders of the UK. The report shows that e-cigarettes are not a gateway to smoking, since the overwhelming majority of e-cigarette users are previous smokers. There is little evidence that vaping is a gateway to smoking for either adult or young "never-smokers". In contrast, vaping is instead a gateway from smoking, resulting in a greater number of quit attempts by smokers, and greater success in quitting. It does not serve to "renormalise" smoking.* The RCP does not deny that the effects of long-term e-cigarette use are unknown. However, it found that all available data points to such harm being "unlikely to exceed 5% of those associated with (cigarettes), and may well be substantially lower."* In other words, the harm from e-cigarettes is almost negligible compared to that from smoking cigarettes. Based on their findings, the RCP believes that public policy should "enable and encourage smokers to use (e-cigarettes) instead of tobacco."* From this report alone, it's obvious that the UK is ahead of the US in its acceptance of e-cigarettes as a safe and effective means to quit smoking. Last year, Public Health England published a well-publicized study revealing that vaping is 95% safer than smoking cigarettes. Thanks to a vocal vaping community, which engaged with policy makers, England's National Health Service will even soon be able to legally prescribe e-cigarettes to help smokers quit. In contrast, the FDA has been dragging its feet on refining regulations, in part because of the supposed lack of evidence. As they stand currently, the FDA's proposed regulations would have a disastrous effect on the vaping industry in this country. The few studies that have come out of the US often fail to take into account real-life usage of e-cigarettes - resulting in skewed results. Examples of this include the formaldehyde scare of last year, or the damaged cells fiasco more recently. Such studies make for splashy headlines. The US media continually spreads misinformation on the subject, by citing bad science, and spotlighting accidents resulting from faulty gear or user error. At this time, it is also fashionable to portray e-cigarettes as a scourge among teens, thanks to a flawed CDC study on the decline of teen smoking and the rise of teen e-cigarette use. On top of that, anti-smoking groups and prominent public figures continue to attack vaping, pushing for stringent regulation. In the absence of federal legislation, many states and cities have begun taking matters into their own hands, passing various bans on e-cigarette use. While the US is in a quagmire over e-cigarettes, the UK is on its way to becoming a world leader in public policy regarding these products. There are many interesting ideas coming out of the country, which may help shape policy in the long run. For example, in a guest article for the Royal Society for Public Health, a Trustee at the New Nicotine Alliance suggests a holistic approach to tobacco harm reduction. Such an approach would recognize that vaping is a viable recreational alternative to smoking, which exists in relation to "a movement and community with its own peer to peer support mechanisms."* Recognizing the unprecedented advantage e-cigarettes can give us in the global fight against cancer is the first step to coming up with common sense policy. The RCP's timely report confirms what many vapers already know: these products can save millions of lives. Here, and elsewhere, e-cigarettes should be embraced and regulated in a common sense fashion, rather than being treated like tobacco by another name.