There seems to be a war on vaping despite proven to be 95% safer nicotine. In the UK the data and all medical bodies draw the same conclusion, so why so much disinformation?
WHO warning on vaping draws harsh response from U.K. researchers
New warnings about vaping issued by the World Health Organization have prompted strong pushback from public health experts in the United Kingdom, who charged that WHO was spreading “blatant misinformation” about the potential risks and benefits of e-cigarettes.
The pointed exchange comes amid growing controversy over the value of e-cigarettes, and how to weigh their role as a smoking cessation tool against their potential harms, especially among young people for whom vaping has soared in popularity. The statements align with others made by U.K. public health officials in recent months, which have generally supported vaping as a useful alternative to traditional cigarettes. In contrast, WHO’s cautions about vaping echo those voiced by the U.S. Centres for Disease Control and Prevention and some U.S. scientists, who are expressing alarm over both known and still-uncertain hazards from vaping. After an outbreak of severe lung disease that’s still being investigated and is linked to THC-containing e-cigarettes, CDC now recommends that e-cigarettes of all kinds “never be used by youths.”
In a document released, WHO expressed reservations about the value of e-cigarettes and grave concerns about their risks. The organization stated “there is no doubt” that e-cigarettes “are harmful to health and are not safe, but it is too early to provide a clear answer on the long-term impact of using them or being exposed to them.” WHO also suggested “there is not enough evidence to support the use of these products for smoking cessation,” and urged smokers looking to quit to try nicotine patches or gum, or other tools such as hotlines that counsel smokers.
The U.K. response was harsh. “The WHO has a history of anti-vaping activism that is damaging their reputation. This document is particularly malign,” Peter Hajek, who directs the Tobacco Dependence Research Unit at Queen Mary University of London, wrote in a statement released today by the U.K. Science Media Centre.
“There is no evidence that vaping is ‘highly addictive,'” he said. “Less than 1% of non-smokers become regular vapers. Vaping does not lead young people to smoking—smoking among young people is at [an] all-time low. … There is clear evidence that e-cigarettes help smokers quit,” Hajek continued.
E-cigarettes are “clearly less harmful” than tobacco, said John Britton, director of the UK Centre for Tobacco & Alcohol Studies and a consultant in respiratory medicine at the University of Nottingham, in similarly critical comments. “WHO misrepresents the available scientific evidence,” he charged. Public Health England maintains that vaping is “at least 95% less harmful than smoking cigarettes.”
This Mail Online article is just one more addition to the negative press that surrounds vaping in the UK. A study was conducted over 6 months and found that 53% of stories related to vaping were negative. That’s over 3 times the number of positive articles that were published. This vaping misinformation and negativity can have a negative impact on smokers wanting to quit.
Luckily, the UK government’s attitude to vaping is completely different. OHID, Cancer Research UK and the NHS all support vaping, due to it being 95% healthier than smoking. In his ‘smoke-free 2030’ recommendations, Javed Khan suggested that vaping be offered as a substitute for smoking. He also suggested that more accurate information be provided to the public regarding vaping. In 2021 OHID reported that only 34% of adult smokers knew that vaping was less harmful than smoking.
What does the UK government say about vaping?
The latest data from several national studies of adults in England shows that:
- smoking prevalence in England in 2021 was between 12.7% and 14.9% depending on the survey, which equates to between 5.6 and 6.6 million adults who smoke
- vaping prevalence in England in 2021 was between 6.9% and 7.1%, depending on the survey, which equates to between 3.1 and 3.2 million adults who vape
- vaping prevalence among adults who have never smoked remained very low, at between 0.6% and 0.7% in 2021
- the popularity of disposable vaping products has increased among adults who vape, with 15.2% using them in 2022 compared with 2.2% in 2021
- tank type products remained the most popular vaping devices (used by 64.3% of adult vapers in 2022)
- vaping products remain the most common aid used by people to help them stop smoking
- in stop smoking services in 2020 to 2021, quit attempts involving a vaping product were associated with the highest success rates (64.9% compared with 58.6% for attempts not involving a vaping product)
- the stop smoking service data are consistent with the latest evidence from the Cochrane living systematic review on electronic cigarettes for smoking cessation which also shows vaping is effective for stopping smoking
What does the CDC say about vaping?
E-cigarettes are not currently approved by the FDA as a quit smoking aid. The U.S. Preventive Services Task Force, a group of health experts that makes recommendations about preventive health care, has concluded that evidence is insufficient to recommend e-cigarettes for smoking cessation in adults, including pregnant adults.
However, e-cigarettes may help non-pregnant adults who smoke if used as a complete substitute for all cigarettes and other smoked tobacco products.
To date, the few studies on the issue are mixed. A Cochrane Review found evidence from two randomized controlled trials that e-cigarettes with nicotine can help adults who smoke stop smoking in the long term compared with placebo (non-nicotine) e-cigarettes. However, there are some limitations to the existing research, including the small number of trials, small sample sizes, and wide margins of error around the estimates.
A recent CDC study found that many adults are using e-cigarettes in an attempt to quit smoking. However, most adult e-cigarette users do not stop smoking cigarettes and are instead continuing to use both products (known as “dual use”). Dual use is not an effective way to safeguard your health, whether you’re using e-cigarettes, smokeless tobacco, or other tobacco products in addition to regular cigarettes. Because smoking even a few cigarettes a day can be dangerous, quitting smoking completely is very important to protect your health.
What does to World Health Organisation say about e-cigarettes?
Are e-cigarettes dangerous?
Electronic cigarettes (or e-cigarettes) are the most common form of electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS) but there are others, such as e-cigars and e-pipes. ENDS contain varying amounts of nicotine and harmful emissions.
E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to both users, and non-users who are exposed to the aerosols second-hand. Some products claiming to be nicotine-free (ENNDS) have been found to contain nicotine.
The consumption of nicotine in children and adolescents has deleterious impacts on brain development, leading to long-term consequences for brain development and potentially leading to learning and anxiety disorders.
Nicotine is highly addictive and some evidence suggest that never-smoker minors who use ENDS can double their chance of starting to smoke tobacco cigarettes later in life.
Evidence reveals that these products are harmful to health and are not safe. However, it is too early to provide a clear answer on the long-term impact of using them or being exposed to them. Some recent studies suggest that ENDS use can increase the risk of heart disease and lung disorders. Nicotine exposure in pregnant women can have similar consequences for the brain development of the fetus.
ENDS use can also expose non-smokers and bystanders to nicotine and other harmful chemicals.
Electronic delivery systems have also been linked to a number of physical injuries, including burns from explosions or malfunctions, when the products are not of the expected standard or are tampered with by users.
Do e-cigarettes cause lung injuries?
There is growing evidence that ENDS could be associated with lung injuries and in recent times e-cigarette and vaping have been linked to an outbreak of lung injury in the USA. This is described by the United States Centres for Disease Control and Prevention (CDC) as e-cigarette or vaping associated lung injury (EVALI), which led the CDC to activate an emergency investigation into EVALI on 17 September 2019.
Lung cancer specialists to publicly promote e-cigarettes
According to the British Lung Foundation “Anyone can develop lung cancer, but around 90% of cases occur in people who smoke or who used to smoke” so understandably, a large part of Lung Cancer Awareness Month revolves around smoking cessation. E-cigarettes are increasingly being promoted as a useful tool to help smokers ditch their habit as well as being “at least 95% healthier than smoking” so it makes sense for campaigners to endorse e-cigarettes as a route to healthier lungs.
The Nursing Times recently announced that nurses at University Hospitals of Leicester NHS Trust, who specialise in Lung Cancer, will be campaigning in Leicester city centre and the endorsement of e-cigarettes will be prominent.
According to Nursing Times, those behind the initiative said, “The “key message” this year is that using e-cigarettes are a “great way” to reduce the harm caused by smoking tobacco”.
It is great to see e-cigarettes recognised as a stop smoking aid and endorsed by professionals in the field of smoking cessation. As the government aims to provide research around vaping that is much more accurate than some of the previous studies, we hope that campaigns like this one, which positively back vaping, become more and more prevalent. This will give smokers the information they need to make an informed decision on whether to make the switch and will help to restore a fair public perception of e-cigarettes.
What does the British Heart Foundation say about e-cigarettes?
The BHF would not advise non-smokers to start vaping.
More research is needed on the long-term impact of vaping on your heart and blood vessels, and on how people can most effectively use e-cigarettes to quit.
A study from the University of Dundee, published in November 2019 and funded by the British Heart Foundation, suggests that vaping may be less harmful to your blood vessels than smoking cigarettes. Within just one month of switching tobacco for electronic cigarettes, measures of blood vessel health, including blood pressure and stiffness of their arteries, had started to improve. The study looked at 114 people who had smoked at least 15 cigarettes a day for at least two years. This is a relatively small number of people, and the study does not prove that vaping is completely safe.
Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “This study suggests that vaping may be less harmful to your blood vessels than smoking cigarettes. Within just one month of ditching tobacco for electronic cigarettes, people’s blood vessel health had started to recover.
“Just because e-cigarettes may be less harmful than tobacco doesn’t mean they are completely safe. We know they contain significantly fewer of the harmful chemicals, which can cause diseases related to smoking, but we still don’t know the long-term impact on the heart and circulation, or other aspects of health. E-cigarettes and vaping should never be taken up by people who don’t already smoke, but could be a useful tool to help people to stop smoking completely.
Stopping smoking and vaping
Smoking-related diseases account for around 100,000 deaths each year in the UK. Most of these deaths arise from one of three diseases: lung cancer, chronic obstructive pulmonary disease (COPD) and coronary heart disease.
According to a 2019 YouGov survey, more than 3.6 million adults in Great Britain use e-cigarettes – 7.1 per cent of the adult population. Of these users, 54 per cent are ex-smokers, suggesting they are helping people to stop smoking.
Martin Dockrell, Tobacco Control Programme Lead at Public Health England, said: “People might be surprised at how much easier it is to quit with an electronic cigarette. Any smoker with a heart condition has almost certainly tried to quit in the past, and failed. Try again with an electronic cigarette because you might find that’s a lot easier. And further down the line, you might want to quit the e-cigarette as well.”
Mr Dockrell added: “We know that e-cigarettes are probably not completely safe, but that’s not the issue. The question is, are e-cigarettes safer than the alternative, It’s really important that smokers understand how much safer e-cigarettes are, compared to smoking”.
What does public health England say about e-cigarettes?
The comprehensive review of the evidence finds that almost all of the 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers, most of whom are using the devices to help them quit smoking or to prevent them going back to cigarettes. It also provides reassurance that very few adults and young people who have never smoked are becoming regular e-cigarette users (less than 1% in each group).
However, the review raises concerns that increasing numbers of people think e-cigarettes are equally or more harmful than smoking (22.1% in 2015, up from 8.1% in 2013: ASH Smoke-free GB survey) or don’t know (22.7% in 2015, ASH Smoke-free GB survey).
Despite this trend all current evidence finds that e-cigarettes carry a fraction of the risk of smoking.
Emerging evidence suggests some of the highest successful quit rates are now seen among smokers who use an e-cigarette and also receive additional support from their local stop smoking services.
Professor Ann McNeill, King’s College London and independent author of the review, said:
There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely.
E-cigarettes could be a game changer in public health in particular by reducing the enormous health inequalities caused by smoking.
Professor Peter Hajek, Queen Mary University London and independent author of the review said:
My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one.
Professor Linda Bauld, Cancer Research UK’s expert in cancer prevention, said:
Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realised based on the evidence assessed by this important independent review. In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco.
It has to be mentioned that the UK and EU have the strictest rules around vaping but a black market still exists. An all-out ban would drive it further underground.
Key facts about tobacco smoke;
- Tobacco kills up to half of its users.
- Tobacco kills more than 8 million people each year. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.
- Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.
- In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.
8 Million avoidable deaths every year due to false information. Let that sink in.
There is so much false information circulating in the mainstream media, CDC, WHO and Twitter “Scientists”
Government plans under-age crackdown
There is now a fast-moving debate on how to tackle vaping by children.
The government plans include a review of rules on fines for shops selling illicit vapes.
By tightening the law, it said it would be easier for local trading standards officials to issue on-the-spot fines and fixed penalty notices to shops which sell vapes to under-age people.
The plans have been welcomed by the UK Vaping Industry Association, which said it had been calling for a clampdown for more than a year.
Its director general, John Dunne, said: “Unless unscrupulous traders know that selling vapes to children is an endeavour which would be financially ruinous to them, then they will continue to do so.”
There has been a rise in experimental vaping among 11- to 17-year-olds – from 7.7% in 2022 to 11.6% in 2023, according to a YouGov survey in March and April, for Action on Smoking and Health.
Two out of five young people said they had smoked vapes “just to give it a try” and one in five because “other people use them, so I join in”.
It is estimated that each year around 207,000 children in the UK start smoking.
Among adult smokers, about two-thirds report that they took up smoking before the age of 18 and over 80% before the age of 18 The 2011 General Lifestyle Survey of adult smokers revealed that almost two-fifths (40%) had started smoking regularly before the age of 16.
The decline in smoking has been most marked among older pupils. The proportion of 14-year olds who smoked regularly fell from 9% in 2008 to 3% in 2018; among 15 year olds, fell from 14% in 2008 to 5% in 2018.
Underage vaping to be targeted by UK government’s ‘enforcement squad’
The crackdown, which will address the illegal sale of e-cigarettes to children, is ‘just the tip of the iceberg’, warn health experts
Ministers are to promise a crackdown on the illegal sale of e-cigarettes to under 18s as they consider stricter rules to tackle underage vaping.
An “illicit vapes enforcement squad”, led by Trading Standards and backed by £3m in funding, will be set up to conduct test purchases and remove banned products from shops and at borders.
The government will also launch a call for evidence to “identify opportunities to reduce the number of children accessing and using vapes”, according to plans expected to be unveiled this week.
The measures come amid rising concern over youth vaping in Britain, with the latest survey by Action on Smoking and Health (Ash) showing a rise in recent years. In 2022, 7% of 11- to 17-year-olds surveyed said they used vapes, compared with 3.3% in 2021.
This comes as welcome news for reputable vape companies and long over-due.
Calling for an outright ban will not only deny ex-smokers the chance of tobacco harm reduction and as previously mentioned would create a black market.
Ex-Smokers Choose Fruit Flavours Over Tobacco
While many tobacco smokers initiated e-cigarette use by choosing flavours which mimicked their old habit – namely tobacco or menthol – over time more are switching to fruit, candy, desert or chocolate flavours and haven’t returned to cigarettes.
The number of first-time vapers choosing non-tobacco flavours to help transition from cigarettes has also rocketed over the past few years.
The revealing statistics are being seen by the vaping community as vital in proving to the US government and pressure organizations that fruit and candy flavoured vape juice is very much used – and has real health benefits – to ex -smokers at a time when cities and states are banning flavours, believing them to be sold as a tool to entice young people into taking up e-cigarettes.
The research published in the Harm Reduction Journal was undertaken because the role that flavours play in the population’s use of e-cigarettes and the impact that flavoured e-cigarette products have on the population’s use of more harmful tobacco products, like conventional cigarettes “has been identified by the US Food and Drug Administration (FDA) as a public health research priority”.
In an online survey, 20,836 adult frequent e-cigarette users in the USA were asked about their first e-cigarette flavour and current e-cigarette flavours. Differences in e-cigarette flavour preferences between current smokers, former smokers, and never-smokers and trends in the first flavour used across time of e-cigarette use initiation were also assessed.
The results showed that the proportion of first e-cigarette purchases that were fruit flavoured increased from 17.8% of first purchases made before 2011 to 33.5% of first purchases made between June 2015 and June 2016.
Tobacco-flavoured first purchases almost halved during this time (46.0% pre-2011 to 24.0% between 2015 and 2016). Fruit/fruit beverage (73.9 to 82.9% of sampled users), dessert/pastry (63.5 to 68.5% of sampled users), and candy, chocolate, or sweets (48.7 to 53.4% of sampled users) were the most popular currently used e-cigarette flavours.
Tobacco and menthol flavours, the two most popular flavours for initiating e-cigarette use prior to 2013, now rank as the 5th and 6th most popular currently used e-cigarette flavours, respectively.
The report concluded: “Adult frequent e-cigarette users in the USA who have completely switched from smoking cigarettes to using e-cigarettes are increasingly likely to have initiated e-cigarette use with non-tobacco flavours and to have transitioned from tobacco to non-tobacco flavours over time. Restricting access to non-tobacco e-cigarette flavours may discourage smokers from attempting to switch to e-cigarettes.”
Pregnant women will be offered up to £400 to stop smoking as part of a push the government has said is “the first of its kind in the world”. One million cigarette smokers will be offered vape starter kits as part of a government “swap to stop” scheme to make the nation “smoke free”.
One million cigarette smokers will be offered vape starter kits as part of a government “swap to stop” scheme to make the nation “smoke free”.
The kits will be offered to almost one in five of all smokers in England as part of a push that is “the first of its kind in the world”
Experts widely expect the pledge to get the nation smoke free by 2030 – equating to getting smoking rates to less than 5% – will be missed without further action.
A choice of products, strengths and flavours will be on offer to allow smokers to find the best product for them.
Officials say this is the first scheme of its kind to be rolled out nationwide.
Funding for the swap to stop scheme – estimated by officials to cost around £45m over two years – will come from the Department of Health and Social Care’s budget.
Officials say 9% of women still smoke during pregnancy in England and hope a financial incentive alongside behavioural support will get all of them to stop by the end of the year.