Public Health England on e-Cigarettes

by | Oct 16, 2017 | Health, Statistics, Vaping

Public Health England (PHE), a government agency, published a detailed report on electronic cigarettes that describes them as far less dangerous than the conventional kind and recommends them as a harm-reducing alternative. “Encouraging smokers who cannot or do not want to stop smoking to switch to EC [electronic cigarettes] could help reduce smoking-related disease, death and health inequalities,” the report says. “Smokers who have tried other methods of quitting without success could be encouraged to try EC to stop smoking, and stop smoking services should support smokers using EC to quit by offering them behavioural support.”

PHE’s position should not be controversial. It is indisputable that vaping, which does not involve tobacco or combustion, is much safer than smoking, and it logically follows that smokers can dramatically reduce the health risks they face by switching. Yet public health agencies and anti-smoking organizations in the United States, unlike their counterparts in the U.K., are strangely reluctant to acknowledge these points, implausibly portraying e-cigarettes as a threat rather than an opportunity. The British example points the way to a calmer, more rational approach that is consistent with the public health goal of reducing the morbidity and mortality associated with smoking.

The PHE report, which was overseen by Peter Hajek, a professor of clinical psychology at the Wolfson Institute for Preventive Medicine, and Ann McNeill, a professor of psychiatry, psychology, and neuroscience at King’s College London, is very clear on the relative hazards of smoking and vaping:

While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger. It has been previously estimated that EC [electronic cigarettes] are around 95% safer than smoking. This appears to remain a reasonable estimate.

The evidence concerning e-cigarettes’ effectiveness in helping smokers quit is more limited but promising:

Recent studies support the Cochrane Review findings that EC can help people to quit smoking and reduce their cigarette consumption. There is also evidence that EC can encourage quitting or cigarette consumption reduction even among those not intending to quit or rejecting other support. It is not known whether current EC products are more or less effective than licensed stop-smoking medications, but they are much more popular, thereby providing an opportunity to expand the number of smokers stopping successfully.

The PHE report warns that misinformation about e-cigarettes, including sensational press coverage of weak or overinterpreted studies, is warping public perceptions of the risks posed by vaping, possibly deterring smokers from making a switch that could save their lives. British surveys indicate that misperceptions have increased in recent years. A survey of adults sponsored by the British group Action on Smoking and Health—which, unlike the American group of the same name, supports e-cigarettes as an aid to quitting—found that the share of respondents who incorrectly described e-cigarettes as “more harmful” than tobacco cigarettes or “equally harmful” rose from about 8 percent in 2012 to 20 percent in 2014. Another 23 percent said they did not know.

There is a need to publicise the current best estimate that using EC is around “95% safer than smoking,” the PHE report concludes. In this country, however, public health agencies and anti-smoking groups seem determined to obfuscate that crucial point.


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