Action on Smoking and Health (ASH) have released their annual ‘Use of e-cigarettes among adults in Great Britain’ survey for 2023, and it has identified that an alarming number of smokers incorrectly believe that vaping is as harmful as smoking, if not more so.
This has prompted them to produce a myth busting brief to help tackle the misconceptions that may be preventing smokers from making the switch to vaping as a way to quit smoking.
Four in ten smokers wrongly believe vaping is as or more harmful than smoking
The latest ASH annual survey has revealed that four out of every ten smokers in Britain incorrectly believe that vaping is as risky or even more risky than smoking cigarettes, which equates to 39% of smokers. This is thought to be one of the main reasons that 1.8 million (27%) of current smokers have never tried vaping, despite that fact that there is an abundance of research finding vaping to be substantially less harmful than smoking, and an extremely effective quitting aid.
Additionally, it was discovered that 2.9 million smokers have tried vaping but stopped and returned to smoking cigarettes, with 44% of this group also having incorrect beliefs about the safety of vaping.
This information has led to concern that these misconceptions around the safety of vaping could threaten the success of the recently announced Government ‘swap to stop’ scheme. This initiative will see one million smokers provided with e-cigarettes as a way to help them quit smoking, and was announced in April this year as a step towards the Government’s aim for England to be smoke-free by 2030.
Speaking on these findings, Hazel Cheeseman, Deputy Chief Executive of ASH said:
“The Government has backed a vaping strategy as its path to reduce rates of smoking, but this approach will be undermined if smokers don’t try vapes due to safety fears or stop vaping too soon and revert to smoking. The Government must act quickly to improve public understanding that vaping poses a fraction of the risk of smoking.”
Busting vaping myths
Whether it is due to simple lack of information, or the negative light that vaping has been shown in through the media, it is clear that tackling the spread of misinformation about the safety of vaping relative to smoking traditional cigarettes is key when it comes to encouraging smokers to make the switch.
Vaping is at least 95% less harmful than smoking
We have known since 2015 that vaping is at least 95% less harmful than smoking, and the Office for Health Improvement and Disparities reiterated this fact in their Nicotine vaping in England: 2022 evidence update.
However, this evidence too often gets lost among the fearmongering headlines, leading many smokers to be unaware that using e-cigarettes is a far less harmful alternative to smoking. Dr Ruth Sharrock, Clinical Lead for Tobacco Dependency, North East and North Cumbria NHS Integrated Care Board shared how this is often evident in her patients:
“When I see patients who smoke they are already sick with smoking-related disease and have often given up hope of ever stopping. Vaping is a valuable tool in our armoury to tackle smoking, particularly for patients who are heavily addicted. However, too many of my patients have seen alarmist media headlines that worry them and put them off giving vaping a go.”
Vaping is twice as effective as nicotine replacement therapies
E-cigarettes in combination with behavioural support is considered the most effective form of smoking cessation, and the most recent Cochrane report found that e-cigarettes are actually twice as effective as other nicotine replacement therapies which are often prescribed to patients like nicotine patches and nicotine gum.
Another one of the reasons that smokers will often give for not wanting to try vaping is that they do not want to swap one addiction for another. However, the addiction to nicotine has already been established during their time smoking cigarettes, and a better way to look at vaping is as a cleaner way to manage this addiction.
Where traditional cigarettes release countless toxic chemicals like tar or carbon monoxide in addition to the addictive substance nicotine, e-cigarettes do not contain these other chemicals and are just a form of nicotine deliver. This allows users to manage their nicotine dependence as they quit smoking, without having to breathe in the many carcinogens that are found in tobacco smoke. It also eliminates secondhand smoke which can pose health risks to those around you, even if they are non-smokers.
Vaping also allows users to closely control their nicotine intake, as e-liquids are available in a variety of different nicotine strengths, making it easy to select the strength that best reflects the nicotine intake they are used to from smoking regular cigarettes, and will best stave off withdrawal symptoms. This also gives them the option to lower their nicotine strength over time, possibly with the aim of completely giving up nicotine in time.
ASH publish vaping ‘myth buster’
To help address the issue of misinformation that was so apparent in the survey, ASH have released a myth busting brief which highlights the many misconceptions around e-cigarettes, including examples of misleading headlines from the media, and provides evidence based rebuttals.
This document has been developed with the country’s leading experts on smoking and vaping and provides evidence on the following topics:
·Vaping is NOT more harmful than smoking
·Vaping is NOT more addictive than smoking
·Vaping is NOT a proven gateway into smoking
·Nicotine DOES NOT damage young people’s brain development
The brief is intended to not only combat misinformation, but to be used as an aid for responsibly reporting information about vaping, and reducing the repetition of such information as conventional wisdom, the overstating of evidence, and instances of opinions being presented as facts.
Vaping is NOT more harmful than smoking
As stated by Chief Medical Officer Professor Sir Chris Whitty:
“The key points about vaping (e-cigarettes) can be easily summarised. If you smoke, vaping is much safer; if you don’t smoke, don’t vape.”
The most obvious evidence to back up this fact is that over 75,000 people die every year from smoking in the UK, in comparison to the fact that in the last twelve years only five fatalities linked to vaping products have been reported to the Medicines and Healthcare products Regulatory Agency (MHRA).
E-cigarette products in the UK are strictly regulated, and these regulations prohibit the use of any ingredients which pose a risk to human health both in heated or unheated form. These regulations have helped the UK become a leading example of how e-cigarettes can be utilised as a crucial aid for helping smokers to quit smoking, and enabled healthcare authorities to endorse vaping as a quitting tool.
Vaping is NOT more addictive than smoking
The brief reveals that two thirds of those who try one cigarette will go on to become regular smokers. Traditional cigarettes actually carry the highest risk of addiction when it comes to nicotine delivery, and for those who manage to quit smoking it takes on average 30 attempts.
As with nicotine replacement products like patches and gum, e-cigarettes are an alternative nicotine source designed to help manage nicotine cravings during an attempt to quit smoking. While this may continue the users addiction to nicotine, which is also true of nicotine replacement therapies (NRTs), it greatly reduces their risk of returning to smoking traditional cigarettes and is a much safer alternative.
Additionally, another way in which e-cigarettes are regulated in the UK is that nicotine-containing e-liquids are limited to a maximum of 20 mg/ml of nicotine. While some countries like the US do not have such restrictions and strengths as high as 50 mg/ml are widely available, UK law ensures that e-liquids can contain enough nicotine to help ex-smokers manage their cravings and remain smoke free, without being excessive.
Vaping is NOT a proven gateway into smoking
As the use of e-cigarettes has increased in the UK, the smoking rates have continued to decline, and are actually at an all time low. If e-cigarettes were in fact a gateway into smoking we would expect the opposite to be true, for smoking rates to stop dropping and even to start increasing, which is simply not the case.
In fact, the data suggests that vaping is a gateway out of smoking traditional cigarettes.
Nicotine DOES NOT damage young people’s brain development
The use of e-cigarettes by young people is something that has been closely monitored for many years, especially in the wake of the large uptake of youth vaping that was seen in the US some years ago. However, youth vaping in the UK has remained consistently low, thanks to the strict regulations that are in place.
A common misconception is that nicotine can be damaging to a young person's brain development, when in fact nicotine replacement therapy is on the World Health Organization (WHO) list of essential medicines due to its efficacy, safety, and cost effectiveness. NRT products are licensed by the MHRA in the UK not just for the use of adults, but also from the age of 12 and for pregnant women, for smoking cessation.
Systematic reviews have found that the evidence on the effects of both nicotine containing and nicotine free e-cigarettes on developing children and adolescents is insufficient or unavailable.
In fact, nearly 90% of lifetime smokers in the UK first started smoking between the ages of 10 and 20, and a Scottish study following a group of children from the age of 11 until they were 70 found that smoking did not have an affect on cognitive function. Therefore, if adolescent smoking does not damage cognitive function, it is implausible to suggest that adolescent use of e-cigarettes would.
That is not to say that this is not something we must remain vigilant on, and combatting youth vaping will always be a high priority. However, it is important that this does not come at the cost of making them inaccessible to adult smokers who could use them to quit smoking traditional cigarettes.
Professor Ann McNeill, King’s College London, author of Government commissioned review on the harms from vaping and contributor to the ASH myth buster, commented:
“Anxiety over youth vaping is obscuring the fact that switching from smoking to vaping will be much better for an individual’s health. It is wrong to say we have no idea what the future risks from vaping will be. On the contrary levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke, which indicates that any risks to health are likely to be a fraction of those posed by smoking.
“We must not be complacent about youth vaping and further regulation is needed, but so too is work to ensure many more adults stop smoking and vaping is an effective means of doing that.”
This brief for tackling vaping myths could prove to be a vital tool in helping to educate smokers on the facts around the safety of e-cigarettes relative to smoking traditional cigarettes, and could go a long way towards reassuring them that making the switch from smoking to vaping is one of the best decisions they could make for their current and future health.
The spread of accurately reported facts and evidence about vaping could also have a great impact on the success of initiatives like the ‘swap to stop’ campaign, and bring us that much closer to the goal of England being smoke-free by 2030.
At a glance
·Four out of every ten smokers (39%) in Britain incorrectly believe that e-cigarettes are as harmful or more more harmful than smoking regular cigarettes
·1.8 million (27%) of current smokers have never tried e-cigarettes, even though they are proven to be less harmful than cigarette smoking and are an effective stop smoking aid
·There are concerns that misinformation about the safety of e-cigarettes could threaten the success of the Government's ‘swap to stop’ scheme
·ASH have released a vaping myth busting brief laying out the facts and evidence around the safety of e-cigarettes relative to smoking and combatting commonly held misconceptions