By Lila Abassi
The Global Forum in Nicotine was held in June and 44 participating countries sent policy analysts, regulators and public health professionals to discuss smoking cessation and harm reduction.
An obvious topic was the role of e-cigarettes as an effective tool in preventing smoking.
The UK Centre for Substance Use Research interviewed 167 young people aged 16-25 years in the UK who ‘vape’ about their usage, and found that the majority of them regard it as socially very distant from smoking, was much less harmful than smoking, and they believe that e-cigarettes make smoking seem abnormal.
In the UK, Public Health England characterizes vaping as being up to 95% less harmful than smoking, while helping smokers attempting to quit. In the US, government officials and those funded by government argue that e-cigarettes could be a gateway to smoking. To-date, however, ‘nicotine naive’ young people who started with e-cigarettes and moved to smoking are so statistically tiny as to be chance.
“There is very little indication amongst the young people interviewed that e-cigarettes were resulting in an increased likelihood of young people smoking,” according to Dr. Neil McKeganey. “In fact the majority of participants we interviewed, including those were vaping, perceived smoking in very negative terms and saw vaping as being entirely different to smoking.”
These are surveys of a specifically chosen demographic. While data from qualitative research can provide a rich, detailed picture that can provide depth by recording attitudes, feelings and behaviors, the downside is that fewer people are studied because of the time-consuming nature of having to conduct 30 minute interviews. That is why it remains difficult to generalize the data to a whole population, and resulted can be skewed if even a few people have outlier answers. That makes meaningful data dependent on the interviewing skills of the researcher. The study was funded by Fontem Ventures, a company that develops non-tobacco alternatives, including e-cigarettes, but the agency conducting the survey has worked for the UN, WHO, and other governmental bodies. (1)
Those limitations noted, the current and former smokers, non-smokers and e-cigarette users acknowledged the extremely harmful nature of smoking cigarettes – and that e-cigarettes were a reasonable alternative.
That won’t stop the public from being bombarded with conflicting results about e-cigarettes. We found that the rate of youth smoking declined from 28 percent in 1991 to 11 percent in 2015 and that is a good thing. But smoking remains a pediatric disease. If people are going to take it up, they will likely do it in youth. So if a teen is going to be rebellious, it is better to experiment with vapor than a cigarette.
McKeganey worries about claims that e-cigarettes are as bad as smoking, and how it will keep smoking around. It’s the key tactic of the ‘quit or die’ mentality that has plagued the modern War on Smoking. “But what was equally clear from our research is that much debated ‘Gateway’ theory is not materializing. There was nothing to suggest that youngsters see vaping as a stepping stone to smoking – quite the opposite.”
(1) It usually goes without saying that funders do not control outcomes in good science. In bad science, they often do. However, anti-science groups insist funding taints everything, except results that match their political and cultural beliefs.
Dr. Lila Abassi, M.D., MPH, received her medical degree from St. George’s University, did her residency at SUNY Downstate Medical Center, and received her BA in Anthropology from University of California – Santa Barbara. She is a physician at SUNY Downstate Medical Center.