By Charlotte Webster
An independent e-cigarette report, commissioned from researchers at King’s College London has been published today alongside new PHE advice on vaping in NHS mental health trusts.It provides an update on the use of nicotine vaping products among young people and adults, and addresses public perceptions of the harmfulness of vaping.
It also takes an in depth look at the evidence on e-cigarette use in people with mental health conditions and pregnant women.
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Current vaping use has remained stable in adults and young people since the last report. PHE is keen to address the increasing number of smokers that now believe vaping is more harmful than smoking. The government’s health body says the belief is out of line with expert reviews from the U.K and U.S concluding that using regulated nicotine vaping products is far less harmful than smoking.
PHE’s advice remains that smokers should switch to e-cigarettes to help them quit smoking, but non-smokers should not take up vaping. It states that E-cigarettes are much less harmful than tobacco but are not completely safe. They contain significantly less harmful chemicals which cause diseases related to smoking but the long-term impact of using e-cigarettes will remain unknown for some time
Chief Medical Officer for England Professor Chris Whitty was clear in his position that he is not suggesting E cigarettes are safe. He said:
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”The best thing a smoker can do for their health is stop smoking completely. Electronic cigarettes can help some people quit smoking and are a safer alternative.
This report is a further welcome contribution to building the evidence around an important area of public policy and highlights the challenge of maximising the opportunities e-cigarettes present while managing the risks associated with nicotine
It is said to negate a mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among UK smokers following the U.S lung injury outbreak in autumn 2019. US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping products, was a primary cause of the US outbreak. This substance is banned from UK-regulated nicotine vaping products.
The report identifies a need for continued monitoring of public perceptions, as the researchers fear that smokers are being deterred by safety fears from using e-cigarettes to quit, which will ultimately cost lives. The report also warns that a ban on flavoured liquids could also deter some smokers from switching to e-cigarettes completely.
”Smokers are advised to continue to be encouraged to try regulated nicotine vaping products along with other stop smoking aids and behavioural support, to increase their chances of successfully stopping smoking. The report also reviews the evidence on vaping among people with mental health conditions and pregnant women, two of the groups among whom the government is focusing its efforts to reduce smoking rates, as set out in the Tobacco Control Plan for England.
The researchers reviewed the literature on vaping among people with mental health conditions and found a small amount of research showing vaping products may reduce smoking, though it acknowledged that further research is needed. They also found that health professionals need better information and training to support people with mental health conditions to use e-cigarettes to quit smoking.
The advice published today wants people to be clear about where people can and cannot vape in hospital grounds and buildings. The researchers also reviewed the available literature on vaping among pregnant women and found that more research is needed to understand the prevalence, safety and effectiveness of using e-cigarettes in pregnancy.
In the meantime, health professionals are advised to use the currently available advice on using e-cigarettes during pregnancy. The report recommends that proof of age at sale of vaping products needs to be better enforced to protect young people and that health professionals should use advice on using e-cigarettes during pregnancy and states that more research is needed into vaping among smokers with mental health conditions and pregnant smoke, and that more research is needed into e-cigarette flavour preferences among young people.
Professor John Newton, Director of Health Improvement at Public Health England, commented on the review:
”It is concerning to see how much the US lung disease outbreak has affected smokers’ views on e-cigarettes here in the UK. Safety fears may well be deterring many smokers from switching, leaving them on a path to years of ill health and an early death due to their smoking. The US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping liquid, was a primary cause of the US outbreak. This substance is banned in UK-regulated nicotine vaping products.
E-cigarettes are far less harmful than smoking, which causes 220 premature deaths a day in England. PHE says its advice remains that for anyone who smokes tobacco, the most important thing is to stop smoking altogether and e-cigarettes can be an effective way to help smokers do that.
Its states that ing in mental health trusts is an important step forward in empowering healthcare professionals to talk more confidently with their patients about the benefits of using e-cigarettes to stop smoking. This advice is another step towards the overall goal of a smokefree generation.
Chief Medical Officer for England Professor Chris Whitty said:
The best thing a smoker can do for their health is stop smoking completely. Electronic cigarettes can help some people quit smoking and are a safer alternative. This report is a further welcome contribution to building the evidence around an important area of public policy and highlights the challenge of maximising the opportunities e-cigarettes present while managing the risks associated with nicotine.
Professor Ann McNeill, Professor of Tobacco Addiction at King’s College London, and lead author of the report said:
”It is currently very hard for smokers to make sense of the many contradictory reports on the impacts of vaping and smoking. In our review we present evidence that suggests in England, vaping has not undermined declines in adult smoking, and for youth, vaping is mainly concentrated in those who were already dabbling in cigarette smoking. However, we need to remain vigilant and ensure that vaping products, alongside regular cigarettes, are not easily accessible to young people.
PHE has commissioned a full review of the evidence on the safety of e-cigarettes, which will be published in 2022. King’s College London said it will work with a number of different researchers from the UK and US (including some who contributed to the National Academies of Sciences, Engineering and Medicine’s e-cigarette report in in 2018) to conduct this review.
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