Electronic cigarette saftey

Electronic cigarette are currently unregulated - so who's using them, do they help people quit smoking, and are they safe?
24 June 2014

Interview with 

Lion Shahab, University College London


Electronic cigarettes - eCigs - are devices that produce nicotine vapour rather electronic cigarettethan burning tobacco; and they're all the rage at the moment.

Perhaps you or your friends are 'vaping', as it's known, instead of smoking real ciggies, and if you live in London you've probably seen the huge glossy adverts on buses.

This week its been revealed that there are currently more than 460 different brands available, and a quarter of people in the EU are likely to have vaped, especially younger ex-smokers.  

But, at the moment, they're unregulated, and there are a lot of questions - such as who's using them, do they help people quit smoking, and are they safe. Dr Lion Shahab spoke to Kat Arney about his work researching smoking behaviour at University College London...

Lion -   E-cigarettes have been around for the last 5 to 6 years and the use has increased dramatically.  Of smokers and recent ex-smokers, 20% have ever used them and currently using them on a daily basis, are around 12%.

Kat -   What do we know about who uses e-cigarettes?

Lion -   It's pretty equally spread across all different age groups.  Generally, it's much more likely that smokers, rather than ex-smokers are using e-cigarettes.

Kat -   So, does it sound like people are using them to quit smoking?

Lion -   There's mixed evidence.  So, some of the population data that we have seem to suggest that people start using e-cigarettes tend to also then be more likely to attempt to stop smoking.  And in fact, the evidence that was recently published in the UK shows that this may be more effective than the use of NRT that's bought over-the-counter.

Kat -   So like gums or patches.

Lion -   Like gums, exactly, like that.  There have been a few randomised control trials, very rigorously controlled trials that have looked at this issue and they suggest that e-cigarettes appear to be as effective as conventional nicotine replacement therapy in helping people to stop smoking, but more research is definitely needed.

Kat -   One of the papers that's currently out at the moment says that there are over 460 different brands of e-cigarettes.  Some of these are being made by big tobacco companies and we're starting to see very glossy adverts that remind me of when I was a child when we'd see these cigarette posters.  What do we know about the kind of the branding and the marketing of e-cigarettes?

Lion -   People have been arguing that some of the flavouring that's been used as marketing to attract younger users.  The evidence also suggests that a very few people start using e-cigarettes completely from scratch as it were, people who have never used cigarettes before.  So, it's only about 0.2% in the UK as far as we can tell.  So, maybe some evidence of marketing may be geared towards younger users.  When we look at smoking prevalence in younger users, there isn't very much evidence that it's actually increasing.  And they're sort of posing arguments in tobacco control field and some people think that the use of e-cigarettes may be encouraging people who would not have used cigarettes at all into starting to smoke.  So, this is the kind of gateway hypothesis.  On the other hand, they're also proponents who will argue that regulation of e-cigarettes, say, banning them may be detrimental because it may actually help people to reduce the harms from smoking by switching them over to a less dangerous product.  So the one thing to remember of course is that cigarettes are particularly dangerous because you smoke them for the nicotine they contain, but you die because of the carcinogens, the cancer causing chemicals are caused by the burning of tobacco.  But as e-cigarettes don't burn any tobacco, nicotine is vaporised which means that they're much less likely to pose a risk to smokers who use them.

Kat -   And what do we know about any potential harms from e-cigarettes?

Lion -   Out there in the literature, there's very little to suggest their long term effects.  And so, new research needs to be carried out and to investigate the associations between what we can measure in the vapour of e-cigarettes.  And so, evidence suggests there are some trace elements that are harmful, certain cancer causing chemicals.  But there's no evidence to suggest that this actually then translates into biomarkers that can be measured in humans and users of these products.

Kat -   If someone's listening to this and they're a smoker and they think, "Ahh, smoking is really not doing my health any good.  Should I try e-cigarettes?"  What would be your advice?

Lion -   My advice working in the field would be that using e-cigarettes certainly is going to be better for you than continuing to smoke.  Consider first of all of course, using effective proven treatments such as the Stop Smoking Services available.  But if that proves ineffective then trying e-cigarette is likely to do more good than harm.


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