Should we recommend vaping to smokers as a means to help them quit, or is it just another way to allow them to continue smoking? And what about kids using these products? Too many of them are starting to vape when they never considered smoking to begin with, putting them on a nicotine pathway to addiction and possible cigarette smoking in their future. This debate of getting smokers to change to vaping versus getting them to quit smoking totally has been going on ever since electronic cigarettes went on the market. In England, e-cigarettes are considered “helpful aids to cessation,” but in the U.S. not only are vapers seen as less likely to quit, these devices are more likely to pull kids into a nicotine addicted lifestyle.
First, it should be noted that this blog is the social media part of the Florida Tobacco Prevention Training for Educators online course, and as a tobacco prevention course, we do not condone youth using any type of nicotine product which will cause an addiction. The studies have shown that nicotine by itself is harmful to the developing brain. And as more research is conducted on e-cigarettes, the evidence continues to show additional health risks, such as increased heart attacks.
But for adult smokers who have high pack years of smoking, could the devices be helpful? As far back as 2015, Public Health England endorsed e-cigarette use and stated “e-cigarettes are significantly less harmful than smoking.” Doctors were not only telling smokers that e-cigarettes might help them quit smoking, but considered them as effective as nicotine replacement therapy (NRT), such as patches or gum. One study said that even after dual use of smoking and vaping, users not only quit smoking, but also quit vaping as well. And as for youth using e-cigarettes, the UK debaters suggest they while they may experiment with vaping, “it is rare for youth to use e-cigarettes on a regular basis.”
According to the con side of vaping, new evidence is suggesting e-cigarette use depresses cessation attempts rather than helps. The original UK optimism that e-cigarettes was the answer to end smoking has even changed with new research. According to a 2018 Public Health England report “there is insufficient evidence from randomized controlled trials about the effectiveness of e-cigarettes as cessation aids compared with no treatment.” But even that trial is questionable as they gave people the e-cigarettes and only gave a redeemable coupon for prescription NRT. People using high dose e-cigarettes seem to quit more, but that is a small percentage (10%-20%); the other 80%-90% of users are less likely to quit. Even a European Union study using information from the UK “found that vapers were less likely to stop smoking than non-vapers.”
There is strong evidence e-cigarettes are a gateway “for addicting new generations of young smokers,” although pro vaping advocates argue against the findings. Analysis of nine published studies associate e-cigarette use with “four times the chance of being a smoker at follow-up compared with youth who had never tried e-cigarettes.” A study in England found 11-18 year olds “never smokers who had ever tried e-cigarettes were 12 times more likely than never users to have become smokers at follow-up (52%).
Youth who never considered smoking are now being pulled into nicotine use. In the US it is estimated that for every adult smoker who quits, “about eight new young smokers” are taking their place. While e-cigarette advocates report their products are safer and less harmful than cigarettes, that harm reduction theory is eroded when “93% of e-cigarette users in the US also reported smoking cigarettes.” Youth in France also report dual use at 83%. And England, a country that reported it was “rare for youth to use e-cigarettes,” had a 60% dual use of both smoking and e-cigarettes.
E-cigarette users may not be exposed to the “70 known carcinogens in tobacco smoke,” but they still inhale chemicals, nicotine and ultrafine particles deep into the lungs and their heart attack risk is much higher than non-users. We already know smokers have a high rate of heart disease; in a study released this year, “daily conventional cigarette smoking resulted in a risk factor adjusted 172% increase in risk of heart attack.” Daily e-cigarette use was associated with a 79% increase in heart attack risk.
It has taken over a century for researchers and scientists to point out the health effects of using tobacco cigarettes- they are still discovering new health risks – and the industry has fought scientific findings all the way. E-cigarette marketing is proving much the same way by decreasing risks by comparing vaping to smoking. We are still in the early days of learning the harms from e-cigarette use, but it is our youth who will pay the price of a lifelong addiction. Great for the vaping industry sales, bad for the health of the next generation.
We already know what smoking will do to your body with all the chemicals, but vaping also has chemicals that can do harm as well. If you are going to compare vaping to something, compare it to not vaping at all. Suddenly vaping doesn’t look as harmless as it seems.