New study and news report add to vaping confusion
Posted on January 25, 2019
A recent study on vaping in young Australian women and a linked news report on news.com.au are misleading and exaggerating the risks and uptake of vaping. The effect of this scaremongering is to confuse and alarm the public about a potentially lifesaving alternative to smoking.
The study, published recently in the American Journal of Preventive Medicine, examined vaping in 8,915 Australian women aged 19-26 years.
I submitted a Comment to correct some of the misleading information in the news.com.au article (twice) but it was not published, so I have written this blog. Following are my responses to 4 of the most misleading statements from the news.com.au article:
1. 'the popularity of vaping among young Australian women is a growing public health concern, with new data revealing how many are taking up the habit'
This comment greatly overstates the popularity of 'taking up the habit' and the risk to public health
The study actually found that vaping by young women who had never smoked was rare: only 1.7% of young women vaped once or more in the last year and had never smoked. We know from other studies that use by never-smokers is largely experimental and short lived, so most young women who had vaped in this study would have done so only once or several times and very few are 'taking up the habit', ie becoming regular users.
Regular vaping by young never-smokers is rare and most do not use nicotine. This represents a minimal risk to public health.
It is also quite possible that vaping may be diverting some non-smokers who would otherwise have gone on to smoke to a far less harmful alternative. Vaping is a more enjoyable and better tasting alternative.
Overall, only 6.4% of young women used an e-cigarette in the last 12 months and the great majority were already smokers. It is a good thing if smokers are switching to a much less harmful alternative, which may lead to quitting.
The only significant risk to public health would be if young women who have never smoked tried vaping, became regular vapers and then progressed to regular, long-term smoking. Evidence from other studies suggests that this is rare.
2. 'Many e-cigarettes contain addictive substances (primarily nicotine) that lead to long-term nicotine addiction, which can affect brain development in young people' and 'There are concerns about the harmful effects of nicotine'
This perpetuates the myth about the harmful effects of nicotine and its addictiveness
Nicotine is a relatively benign recreational stimulant without significant adverse effects.
The Royal Society of Public Health says nicotine, when separated from smoke 'is no more harmful than caffeine'. According to the Royal College of Physicians, 'Use of nicotine alone, in the doses used by smokers, represents little if any hazard to the user.'
Nicotine is also less addictive when delivered without smoke. Smoke contains other chemicals such as Monoamine Oxidase Inhibitors which enhance its addictiveness. Many studies have shown that vaping is less addictive than smoking.
There is also no evidence than nicotine can affect brain development in adolescent humans, although there is some evidence for this in rats and mice.
3. 'some research indicated that e-cigarette users were more likely to go on to smoke cigarettes'
This statement implies (but does not state) that vaping entices young people who would never have smoked to take up smoking long-term, the so-called 'gateway effect'
However, there is no credible evidence to support the theory that vaping causes smoking although this may occur in a very small number of cases.
In fact, it is likely that vaping is reducing smoking rates. Most young people who experiment with vaping are already regular smokers. Since vaping became popular in the US in 2014, the long-term decline in youth and young adult vaping has accelerated and is now three times faster then before. Adult smoking rates have also declined at historic rates.
A more plausible explanation for vapers being more likely to later taking up smoking is 'common liability' for substance use. Young people who are impulsive, rebellious and sensation-seeking are more likely to try both behaviours.
4. 'Fellow researcher Dr Catherine Chojenta said e-cigarettes were touted as being a healthier alternative to tobacco and a quit smoking aid but the scientific evidence was not there yet'
This statement falsely implies that harmful e-cigarettes are being incorrectly claimed to be less harmful than smoking.
While vaping is not risk-free, most scientists accept that it is far less harmful than smoking. Several independent health bodies have stated that the risk of vaping is no more than 5% of the risk of smoking (here, here and here).
Almost all of the harm from smoking is due to the tar, carbon monoxide and 7,000 toxic chemicals produced by burning tobacco. In contrast, the aerosol inhaled from vaping devices contains a fraction of the chemicals and those present are mostly at concentrations less than 1% of the levels in smoke.
The evidence to date is reassuring on safety, but ongoing monitoring and research is essential as unknown risks from vaping may appear with long-term use. However, based on what we know (which is a lot) vaping is certain to be far less harmful than smoking which kills up to 2 in 3 long-term users.
Posted by Colin Mendelsohn, firstname.lastname@example.org