NHS goes "merchant of doubt" on vaping as an alternative to smoking

Sometime in July 2026, a small but significant change was made to the National Health Service (England) website on vaping. It has really disturbed me. Am I overreacting?

​I noticed a small but significant change to the NHS website’s advice on vaping as an alternative to smoking: Using e-cigarettes to stop smoking

From April 2019 up to 3rd July 2026

Also known as vapes or e-cigs, they’re far less harmful than cigarettes, and can help you quit smoking for good

​After 29 July 2026 - to the present

Also known as vapes or e-cigs, they’re likely to be far less harmful than cigarettes and can help you quit smoking for good.

So, they are now “likely to be”​ far less harmful after seven years of being confidently far less harmful.

Of course, anyone can justify qualifying any unequivocal statement: the whole statement could be loaded with caveats, disclaimers, and sub-clauses to the point of it becoming meaningless and ineffective (the US FDA approach).

But if you are communicating advice to the public or professionals who deal with the public, what is the effect of this introduction of doubt? Many will surely conclude “they don’t really know”, and that will reinforce entrenched risk misperceptions, which are already terrible and getting worse.

• 54% believe vaping is as/more harmful than smoking

• Misperceptions are highest among smokers who have never vaped (61%) and smokers who have stopped vaping (58%)

  
  Action on Smoking and Health, July 2026

It is beyond reasonable doubt that these products are far less harmful than cigarettes, and there is no credible evidence to suggest otherwise.

The term Merchant of Doubt is usually explained with reference to a 1969 statement from a tobacco industry executive in an internal document.

“Doubt is our product, since it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public. It is also the means of establishing a controversy.”

UCSF industry document archive

In this case, doubt reinforces misperceptions in the minds of the public that are likely to protect the cigarette trade.

My take

When statements are qualified in this way, it has nothing to do with the well-being and interests of the target audience (people who smoke, in this case). This change will be negative for smoking cessation and harmful to health. It is more likely grounded in back-covering and retrenchment on the part of the entity making the statement. It is serving their interests, not those of the people they serve. In this case, it has probably been done to align with the anti-vaping zeitgeist of the Labour government and the misguided, misanthropic attitudes of much of the public health establishment.

I started by asking, "Am I overreacting?" I don't think so... many lives are at stake, and doubt is a killer.

Update - less harmful or substantially less harmful?

Update added 17 August 2026.

Super-sleuth Jukka Kelovuori has uncovered (here, here) more instances of decommitment and doubt merchandising in NHS communications

NHS Better Health website: Vaping to Quit Smoking

Before (19 February 2025)

Nicotine vaping is substantially less harmful than smoking.

After (23 February 2025)

Nicotine vaping is less harmful than smoking.

NHS Better Health website: Vaping myths and the facts

Before (14 February 2025)

Nicotine vaping is not risk-free, but it is substantially less harmful than smoking.

After (4 March 2025)

Nicotine vaping is not risk-free, but it is less harmful than smoking.

The problem here is that “less harmful” as a risk communication sits somewhere between meaningless and misleading. The right expression, given what we know of the risks, would be “substantially less” or “much less” or “far less” or “a small fraction of the risk”.

Just saying “less harmful” is misleading because it is misdirection by omission: if something was 80% to 99% less harmful, you would not describe that as merely less harmful. You would use a more emphatic modifier, such as substantially, much, or far less. So leaving it without a modifier is misleading and reinforces inflated false perceptions of risk compared to smoking.

Just saying “less harmful is also meaningless if taken literally. Does it mean 1% or 11% or 30% or 75% or 95% or 99.8% less harmful? All are literally “less harmful”, but they vary by three orders of magnitude. Risk communication is meaningless unless language is used to convey magnitude or materiality. That can be imprecise language like “substantially less” or “far less” but it conveys a quantitative sense of scale.