It’s no secret that quitting smoking is one of the best things you can do for your health, but for many people that is easier said than done. A recent article published on Patient.info entitled ‘Is Vaping Safe? The Truth about Vaping’ discusses how vaping can be used as a tool to help people quit smoking, the relative risks of e-cigarettes compared with smoking, and why vaping has received some negative press in the past.
The article by Milly Evans was reviewed by Dr Sarah Jarvis MBE, who is a trained GP and a clinical consultant for Patient.info, as well as being the resident doctor on shows like BBC’s The One Show for over ten years.
How do we know e-cigarettes are less harmful than smoking?
The article takes a look at what research there is to support the statistics relating to vaping.
In 2015 PHE (Public Health England) concluded that e-cigarettes are 95% less harmful than smoking, a spokesperson explains;
"PHE's 2015 independent e-cigarette evidence review agreed that, based on the available evidence, the figure was a reasonable estimate. The Royal College of Physicians came to a similar conclusion in its 2016 report."
E-cigarettes do not create the thousands of harmful products that cigarettes do upon combustion, as Dr Nick Hopkinson, Medical Director at the British Lung Foundation, explains;
"Cigarettes are a uniquely risky and harmful product because tobacco smoke contains over 5000 chemicals. When people smoke, these chemicals damage the lungs but also pass into the bloodstream and spread through the body. Whilst people smoke because they become addicted to nicotine, they are harmed by the tar and other chemicals, including carbon monoxide. Smoking causes around 7 out of every 10 cases of lung cancer and can also worsen symptoms of lung conditions such as asthma. Smoking not only harms the lungs but also causes heart attacks, strokes and cancer."
When considering whether to start using an e-cigarette it is all about the relative risks. If you are a non-smoker, then it is not advisable to begin using an e-cigarette. However, if you are a smoker, moving to an e-cigarette would cut out the vast majority of the harmful substances being introduced to your body, and reduce the risk of smoking related illness.
"E-cigarettes are not risk-free but they are far less harmful than cigarettes. E-cigarettes don't contain tobacco and don't produce tar or carbon monoxide, two of the most harmful constituents in tobacco smoke," explains PHE's spokesperson.
But e-cigarettes contain nicotine, isn’t that bad?
E-cigarettes will often contain nicotine, but this is entirely the choice of the user. E-liquids are available without nicotine, however some nicotine content is recommended to new vapers as this will help keep any cravings at bay as they make the switch from smoking to vaping.
The body reacts to nicotine in the same way it would to substances like caffeine, which causes increased blood pressure and heart rate, however, nicotine itself is not known to cause cancer and carries much less risk than the numerous harmful ingredients found in tobacco.
Nicotine replacement therapy has been used for smoking cessation for years, such as nicotine patches or inhalers, and nicotine is not the main risk factor related to smoking.
"E-cigarettes are part of a menu of options to help people quit smoking, and can be a very effective quitting tool," says Hopkinson.
"A study from Queen Mary University of London found that e-cigarettes are almost twice as effective as nicotine replacement treatments, such as patches and gum, at helping people quit smoking when they're also given behavioural support. E-cigarettes may work in particular for people who have tried other ways of quitting but haven't been successful."
Why are some smokers so wary of vaping?
As discussed in the article, over the years there has been a lot of misinformation in the media about the relative risks of vaping in comparison to smoking. Unfortunately, following a bout of deaths related to THC vapes in America at the end of 2019, the number of smokers who correctly believe that vaping is less harmful than smoking has fallen to just 48%. This is worrying when you consider that in the UK 78,000 people die every year from smoking, and this number doesn’t include the countless cases of hospital visits that do not result in death.
As of January 2020 over 2600 reports had been made of people hospitalised with EVALI (e-cigarette or vaping product use-associated lung injury) across the US. In the majority of these cases, the person has admitted to using unregulated THC vaping products, often purchased on the black market. The damage was found by the CDC to be caused by the vitamin E acetate used in these products.
These issues were not experienced in the UK, and were not linked to the use of regular vaping products being used in the manner they were intended. However, it took some time for this to be reported by news outlets and by the time the true nature of the illness was widely reported some damage had already been done to the reputation of e-cigarettes, with many people falsely believing that e-cigarettes are just as harmful as smoking. A big part of this seemed to be because the deaths got so much media attention, but the reason that the EVALI deaths in the US were so widely reported is because they are so uncommon, whereas smoking related deaths are so common that they are not regularly reported on.
Both THC and vitamin E acetate are prohibited from use in the manufacture of vaping products in the UK, where nicotine containing products are strictly regulated. The MHRA (Medicines and Healthcare products Regulatory Agency) are responsible for overseeing the regulation of quality and safety of vaping products and they operate a yellow care scheme that allows users to report any adverse effects that could be linked to the use of such products. It is also important to recognise that the way in which the US regulates vaping products is much different from the UK.
Public Health England were quick to reassure UK vapers and smokers with the following advise;
"PHE's advice on e-cigarettes remains unchanged, that they carry a small fraction of the risk of cigarettes, that smokers should consider switching completely and vapers should stop smoking."