Photo credit: Jonny Williams www.ecigclick.co.uk
According to a recent report by Public Health England (a neutral government body in the U.K. with no ties to Big Tobacco) vaping is 95% less harmful than smoking, and they encouraged the use of e-cigarettes as a way to help smokers quit.
For those not game enough to read all 111 pages of the full report (like me), the abridged version is here.
For those of you who would much rather read a blog post than an abridged U.K. government health body report, let's break down the main points:
1. Vaping rates increase, smoking rates decrease
The report found that over the four-year period between April 2011 and March 2015, e-cigarette use in England increased from almost 0% to over 5%.
Over the same period, cigarette use in England declined from 21% to just over 18%. This decline was in both adult and youth usage.
Correlation or causation?
The report doesn't go as far as to claim that the two are directly related, which would be fallacious. It's still interesting though, and worth noting along with the other data points in the report.
2. Most vapers are almost exclusively ex-smokers
The report found that the overwhelming majority of e-cig users are those who either used or are using e-cigs to quit tobacco: ~60% still smoke, ~40% have stopped smoking, with the estimated e-cig use of never-smokers around 0.2%. This flies in the face of some experts who claim e-cigs are a gateway to tobacco use for young people who have never smoked.
The 0.2 percent?
So it would appear some young people are using e-cigarettes, then switching to conventional tobacco, because all of the adult e-cig users are current or ex-smokers.
This has been one of the catch cries of the anti-e-cig movement - that e-cig use will "re-normalise" tobacco use, and encourage young people who would not have smoked otherwise to smoke. I have two fairly big problems with this line of thought:
1. Correlation does not equal causation.
There is no evidence at all to support the claim that these young people would never have tried cigarettes if it weren't for e-cigs. Furthermore, how would you even go about getting such evidence?
2. Horses for courses
If you think about it for - oh, I don't know - five seconds, the type of young people who are likely to be attracted to e-cigarettes are exactly the type of young people who are also likely to be attracted to tobacco cigarettes, and goodness knows what else besides.
3. E-cigarettes have become England's most popular - and most successful - quit smoking aid
E-cigs, e-liquids and advanced personal vaporizers (APVs) are unregulated devices intended for personal use. They are not quit-smoking aids, and are not advertised or sold with these claims. In spite of this, many people who buy e-cigarettes and related products take it upon themselves to use them for this purpose, and as this report suggests, have found great success doing so.
One self-reported study found that 35% of all smokers trying to quit use e-cigs, with the next most popular method of over-the-counter aids such as patches, oral sprays and gums coming in at just over 20%.
In another self-reported study, smokers using only unlicensed nicotine-containing products (i.e. e-cigs) enjoyed a 66% quit rate after four weeks. This was a better outcome than all other forms of therapy, including prescription medication.
Crossing the legislative line?
In Australia, e-cigarettes are not approved as smoking cessation devices by the Therapeutic Goods Association, and anyone caught marketing e-cigs as such will find themselves in hot water.
But there are plenty of ways to quit smoking; only a handful are regulated, and not all of them are legal. So however you do it, quitting smoking is the best thing you will ever do, short of inventing time travel and convincing yourself never to start in the first place.
4. The current "best estimate" is that e-cigarettes are 95% less harmful than tobacco cigarettes
This makes for a catchy headline, but be aware this is a "best estimate" based on the current literature on the safety of e-cigs. If you've ever had a look through this, you'll see there is a lot of variation in the outcomes.
Worth noting is that PHE has been gathering this data since early 2014, so as far as "best estimates" go, this one has some decent weight behind it.
- most of the chemicals that cause smoking-related illness are absent from e-cigarettes
- the chemicals that are present pose little to no danger
- e-cigs release negligible amounts of nicotine into ambient air and pose no health risks to bystanders
Let's put this into context. You're playing Russian Roulette and can choose between two guns. One has 95% less chance of firing a bullet than the other one. Which one will you pick? Yeah, thought so. The obvious flaw in my little analogy being why are you playing Russian Roulette in the first place, but - you catch my drift.
What this means for vaping in Australia
Initially, not a great deal. But PHE prepared this report to inform the government about legislation they are preparing to pass on e-cigarettes. The report made several recommendations, namely:
- e-cigarettes represent a real and effective way to quit smoking and carry a fraction of the risks of smoking;
- appropriate legislation will ensure e-cigarettes realise their full potential to help stop smoking without providing a path into smoking for children and never-smokers;
- e-cigarettes should be considered as a wide-reach, low-cost quit smoking aid;
- legislation should consider the potential of e-cigarettes to curb smoking rates in disadvantaged societal groups;
- legislation should consider the potential of e-cigarettes to tackle the high smoking rates among people with mental health problems, and accordingly the opportunity to create smoke-free mental health units;
- smoking cessation services should not discourage people who want to quit from using e-cigarettes;
- health and social care workers need to be educated about the risks and benefits of e-cigarette use;
- the general public need to be educated about the risks and benefits of e-cigarette use.
Whilst Australia generally follows American legislative lead over Europe, if major changes take place in England that see real and dramatic results (which we all know they will if they are sensible about it), we may see many more people saved from smoking in the same way we all have.