Britain is on the brink of a revolution in smoking which aims to eradicate the cigarette.
Companies, including some of the biggest names in tobacco, are poised to launch a generation of devices that mimic the experience of smoking without the lethal effects.
One, being developed by a 29-year-old Oxford graduate, has attracted the attention of BAT, one of the world's largest tobacco companies, which has bought the rights to market it. A profusion of electronic and other devices has appeared in the past year, thanks to a legal loophole which allows them to be sold freely so long as they do not make any health claim .
An estimated 10 million "e-cigarettes", which are shaped to look like the real thing and simulate smoking by heating nicotine to produce an inhaled mist, have been sold worldwide. Other devices, similar to asthma inhalers, deliver the nicotine as a vapour or powder drawn directly into the mouth or lungs.
UK regulators are considering ways to bring the new devices within the law but campaigners are insisting on "light touch" controls which could make it legal to market them in newsagents and supermarkets alongside cigarettes. Pure nicotine, though highly addictive, has few side effects and a low risk of overdose – it is the tobacco in which it is contained that is lethal.
But the idea has caused alarm among some experts, who say it is wrong to promote nicotine dependency. The Medicines and Healthcare Products Regulatory Agency, which licenses medicines, has begun a programme of research following a consultation exercise on the risks to consumers from the products and the impact of regulation. It is due to make a final decision on how to regulate them by spring 2013.
The Royal College of Physicians has called for the devices to be made more widely available. In a 2007 report, the college argued for a "harm reduction" approach which aimed to move smokers on to safer substitutes, to supplement the existing therapeutic approach using nicotine patches and gum to help smokers to give up. The Cabinet Office's behavioural insight team has backed the new technology. In its report in September, the unit said: "If alternative and safe nicotine products can be developed which are attractive enough to substitute people away from traditional cigarettes, they could have the potential to save 10,000s of lives a year."
John Britton, professor of epidemiology and director of the UK Centre for Tobacco Control Studies at the University of Nottingham, said: "There are very few areas where the UK leads the world, but we do on this. We have a government that is considering changes to the way nicotine is sold and marketed which has the potential to save thousands of lives in this country and millions worldwide. No other country is doing this – but a lot are watching."
Responses to the MHRA consultation mostly supported a form of "light touch" regulation which would ensure the devices were safe but would not deter companies by requiring them to conduct expensive trials as for medicines. But some organisations, including local authority regulators, the Trading Standards Institute and the Chartered Institute of Environmental Health warned that e-cigarettes were "bypassing all legislative controls" and posed a safety risk to users and a danger to children.
The Local Authorities Coordinators of Regulatory Services called for e-cigarettes and similar devices to be licensed as medicines, like nicotine patches and gum. Experts say this would effectively amount to a ban, as manufacturers would not pay for the necessary clinical trials.
Others warn that making the devices widely available could lead to non-smokers becoming addicted or act as a "gateway" to tobacco for children.
Most e-cigarettes are made in China. A survey for Ash, the anti-smoking charity, found one smoker in 10 had tried them and 3 per cent had continued to use them. A spokesman for Ash said: "E-cigarettes have taken off in the last year. Companies are taking the opportunity to market them while they are unregulated. We think light touch regulation is a sensible way forward. Compared to smoking, they are not nearly as harmful. But there is still too much uncertainty about their safety."
Case Study: Ex-Tesco boss backs new 'safe' cigarette
Alex Hearne believes he has cracked the problem that has defied efforts for 50 years – developing a safer, satisfying substitute for the cigarette.
The 29-year-old entrepreneur and inventor, who studied classics at Oxford University, claims to have discovered how to deliver medicinal nicotine into the lungs in a way that does not risk smokers' health.
He says his device, similar to an asthma inhaler, provides "all the psychological cues and sensations of smoking."
He is backed by Sir Terry Leahy, ex-boss of Tesco. His company, Kind Consumer, has sold the marketing rights to British American Tobacco, which has set up an arms length firm, Nicoventures, to boost the device. Nicoventures aims to apply for a licence to allow the device to be marketed as a "treatment" for smokers, like nicotine gum or patches
The tobacco market is worth some £12.5bn a year. Yet spend on nicotine substitutes is £100m and fewer than one in five smokers like the products. Mr Hearne says: "The thing that sets our invention apart... is not just the fact it mimics the psychological rituals and routines of smoking cigarettes, but that it is designed to match the physiological effects of nicotine in-take by smokers."