The medical report published this week which finds that vaping could save millions of lives and should be encouraged could be read as a victory for the Marlboro Man of our times, who has swapped his horse for a helicopter and become a woman.

Perhaps you’ve seen the glossy new TV ad, below, and its evocation of an age when cowboys sold a deadly lifestyle. In summary: helicopter corrals cows under big skies, lands next to massive rock; pilot wearing stetson gets out, pulls down bandana and puts an electronic cigarette in her mouth. Its tip glows blue before the setting sun catches the vapour cloud as she exhales.

Facebook Twitter Pinterest Pilot – Just You & blu (TV commercial)

It’s big-budget and kind of beautiful. But the ad, for Blu eCigs, part of Imperial Tobacco, comes at a tricky time in the rise of an awkward object. Conceived as a nicotine vehicle to deliver the physical, social and chemical appeal of smoking without the aftertaste of death, the electronic cigarette, used by an estimated 2.6 million people in Britain, has rapidly spawned a sub-industry and vaping culture.

But like a curious teenager clutching an Embassy behind a bike shed, we don’t quite seem to know what to do with these new sticks, or what the risks might be. Just as the the Royal College of Physicians (RCP) called on Thursday for the promotion of vaping in the biggest report of its kind, new rules are about to make e-cigarettes harder to buy – and kill off the Blu Woman before she’s even got going.

The EU Tobacco Products Directive, which comes into force on 20 May, will, among other things, outlaw the advertising of electronic cigarettes on TV, radio and in newspapers. It will also set a limit on the nicotine content of the liquid used in the devices, which use a small, battery powered heating element to create the inhalable vapour (the “e-liquid” or “juice” is a blend of organic compounds, natural or synthetic flavourings and nicotine).

Facebook Twitter Pinterest An employee checks e-cigarettes at a factory in Shenzhen, in the southern Chinese province of Guangdong. Photograph: Tyrone Siu/Reuters

The directive follows years of conflicting advice and regulation. There is no public ban on e-cigarettes but local policy varies. You can vape to your lungs’ content inside a Westfield shopping centre, but stray over the carpet into a Starbucks and you’re banned. Doctors haven’t been able to agree either. In 2014, the World Health Organisation said vaping could be dangerous. A year later, Public Health England said it was 95% less harmful than smoking, but its evidence was subsequently doubted in the Lancet.

Perhaps Prof John Britton, chair of the RCP’s tobacco advisory group, which produced the new report, can help navigate this fug of confusion. “A lot of it is psychological,” he says. “There are people who feel sustaining nicotine addiction is wrong. I’ve had those conversations at conferences over coffee, and nobody has seen the irony in it.” Nicotine isn’t something to seek out but “like caffeine, if it is used in the doses in which smokers use it, it is not significantly hazardous,” Britton adds. “The important thing is to separate it from the smoke, which is what electronic cigarettes do.”

The RCP report “lays to rest almost all of the concerns over these products”, including any suggestion that secondhand vapour can be harmful. But it will be harder to stub out the connotations of smoking. Almost 10 years after the public smoking ban, and more than half a century after the RCP’s pivotal 1962 report, Smoking and Health, which changed our relationship with cigarettes for ever, we are bound to doubt a solution that looks like the problem. Moreover, as the tobacco multinationals catch up with a runaway trend, and sell that solution as a lifestyle, we are understandably wary of the motivations of an industry which has not always welcomed the advice of doctors.

Facebook Twitter Pinterest A vaper at an e-cigarette shop in Covent Garden, central London. Flavour seekers tend to prefer fruit or perfumed varieties. Photograph: Rex/Shutterstock

“There’s a suspicion of a commercial, consumer-led rather than medical response,” Britton accepts. “And there are arguments that these products are being used to promote smoking subconsciously … and that the tobacco industry will exploit them to sell more tobacco, particularly in countries with poorer governance.” The professor of epidemiology welcomes proportionate regulation, including the ad ban, as well as theforthcoming move to allow doctors to prescribe licensed vape kits. But while 200,000 children still take up smoking every year in Britain, he believes the participation even of public health villains is a price worth paying if it reduces illness and about 100,000 deaths a year (that’s about one every five minutes).

“We still have nearly 9 million people smoking tobacco every day when we’ve known what to do about it pretty much since 1962,” Britton says. “That’s a reflection of an abject failure of health policy. We’re reducing the number of young people taking up smoking, but we’re not that much better at helping them quit. That’s why the e-cigarette is such a powerful new tool.”

Marc Michelsen is, unsurprisingly, inclined to agree. “We have had an issue with public trust,” admits the public affairs executive at Fontem Ventures, the Dutch firm which owns Blu, and is an “arms-length subsidiary” of Imperial, the British tobacco company. “But a lot of that comes from a lack of scientific understanding.” Blu is delighted with the RCP report, but less keen on the advertising ban. “If you inhibit advertising, fewer people will buy the product and that can’t be good,” adds Michelsen, who denies that Blu’s commerical is a barely veiled Marlboro reboot. “I think it’s pure Mad Max,” he suggests (I must have missed the pastoral scenes in Fury Road). “This campaign is not about the past, we’re looking forward.”

Facebook Twitter Pinterest A Marlboro billboard in Los Angeles, circa 1976. Photograph: Alamy

What do vapers think, and who are they anyway? The majority of electronic smokers buy mass-produced products in supermarkets or online, and don’t think a great deal about them beyond their health and financial savings (£200 a month for a 20-a-day smoker, according to vape sites). But a vaping scene has unexpectedly mushroomed to the extent that, for many vapers, nicotine has become a secondary interest.

At the Vape Emporium, a London-based online store with boutiques at Hampstead and Richmond, a vape consultant will talk you through a menu of handcrafted e-pipes and more than 200 flavoured e-liquids. Perhaps you’d like to try the VG by Simple Chocolaccino, which “blends caramel, chocolate, coffee and biscuit for a divine morning vape”. “We now have juices that only contain 1.5mg of nicotine, which is tiny,” says Andy Logan, the emporium’s co-founder. A 24mg/ml mix compares to a strong cigarette, he explains (the new rules will set the maximum at 20mg). “And some people are taking zero nicotine now because they just don’t need it but still enjoy vaping.”

Logan, who set up as an online store in 2013 and is looking for new shopfronts, says vapers follow a familiar path. “At the start they’re adamant they don’t want any funny flavoured rubbish and go for a strong, tobacco-style vape. But after a few weeks they’re trying some crazy flavours and dropping the nicotine because they’ve got their tastebuds back.” Flavour seekers tend to favour fruit, pudding (doughnuts and cakes are popular) or mint and vanilla perfumes, he adds. Some go further, vaping socially in cafes and clubs and discussing equipment and blends. Logan has just exhibited at the second Vape Jam UK, a three-day expo at London’s ExCel centre attended by 300 companies and clubs. “I took my fiancee on the Sunday,” he says. “She had no idea this subculture exists. It’s quite amazing.”

Facebook Twitter Pinterest Figures show public response to vaping is catching up with its rise in popularity. Photograph: Christopher Thomond/The Guardian

Logan says his customers range from an insanely knowledgable 94-year-old woman to a businessman who comes in for a puff while his driver idles outside in a Bentley. Vaping is increasingly popular among young people (it is illegal to sell to under-18s), he adds. Meanwhile, the public response to vaping – while still generally somewhere between curious and hostile – is catching up with its rise in popularity. “I still can’t go to a party without facing a barrage of questions, but it is changing,” Logan says.

As a culture emerges and big tobacco piles in with huge advertising budgets, do we risk discouraging nicotine quitting, or even drawing non-smokers into addiction? “Our annual survey of 12,000 adults suggests the level of vaping among non-smokers is steady at about 0.2%, says Hazel Cheeseman, director of policy at Ash, the smoking health charity.

“It’s extremely rare and I don’t think that will ever change,” Logan adds, rejecting the gateway hypothesis. And he doesn’t need it to. “If there are nearly 10 million smokers and only 2 million vapers, we’ve still got a massive, long journey to convert the rest,” he says.