We need more trials into the long-term impacts of e-cigarettes, but is disagreement between scientists over their effects putting people off taking part?
Whenever I tell anyone I research e-cigarettes, they almost always have an opinion about them. Some will be vapers themselves, and those who are will almost without fail sing the praises of the device that finally helped them quit smoking. But often people who’ve never tried e-cigarettes will focus on the potential risks from using them, and in particular whether they’re likely to reintroduce smoking to a young generation who have been steadily shunning it in larger and larger numbers over recent decades. A particular fear is that young people will experiment with e-cigarettes and that this will be a gateway in to smoking, as well as fears around the harms from e-cigarettes themselves.
A recent detailed study of over 60,000 UK 11-16 year olds has found that young people who experiment with e-cigarettes are usually those who already smoke cigarettes, and even then experimentation mostly doesn’t translate to regular use. Not only that, but smoking rates among young people in the UK are still declining. Studies conducted to date investigating the gateway hypothesis that vaping leads to smoking have tended to look at whether having ever tried an e-cigarette predicts later smoking. But young people who experiment with e-cigarettes are going to be different from those who don’t in lots of other ways – maybe they’re just more keen to take risks, which would also increase the likelihood that they’d experiment with cigarettes too, regardless of whether they’d used e-cigarettes.
Although there are a small minority of young people who do begin to use e-cigarettes without previously being a smoker, as yet there’s little evidence that this then increases the risk of them becoming cigarette smokers. Add to this reports from Public Health England that have concluded e-cigarettes are 95% safer than smoking, and you might think that would be the end of the fear surrounding them.
But e-cigarettes have really divided the public health community, with researchers who have the common aim of reducing the levels of smoking and smoking-related harm suddenly finding themselves on opposite sides of the debate. This is concerning, and partly because in a relative dearth of research on the devices the same findings are being used by both sides to support and criticise e-cigarettes. And all this disagreement is playing out in the media, meaning an unclear picture of what we know (and don’t know) about e-cigarettes is being portrayed, with vapers feeling persecuted and people who have not yet tried to quit mistakenly believing that there’s no point in switching, as e-cigarettes might be just as harmful as smoking.