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Vaping – is the jury still out?

Is vaping the solution for smokers who want to quit?

We know that many people have successfully used e-cigarettes to quit smoking. The Medicines and Healthcare Products Regulatory Agency recently awarded a licence to allow the e-Voke brand to be marketed as a smoking cessation aid – the first time an e-cigarette has received such a licence.

However, there are mixed reports in the media, and some people think ‘vaping’ could be just another route to ill health. Headlines last month, based on research from the University of California at San Diego, went as far as to say that ‘e-cigarettes cause cancer’. Although this research has been widely criticised, we know there is uncertainty about the health effects of e-cigarettes. Many will no doubt be worried about whether they should be suggesting vaping as a safer alternative to smoking.

In order to look at this, let’s consider smoking cigarettes first, so we can put e-cigarettes in context.

Smoking tobacco is the single biggest avoidable cause of death in our country. If people develop a smoking-related lung disease like lung cancer or COPD, the damage is irreversible. It’s a very real problem for smokers and their families, causing symptoms like breathlessness, wheezing and chronic coughs. Around half of long-term smokers will die as a result of their habit; research last year suggests this figure could be as high as two thirds.

And with around 10 million smokers in the UK today, it is a huge burden for the NHS. It’s estimated that treating smoking-related diseases costs the NHS around £2 billion every year. Once you take factors like smoking-related sick days, premature deaths and fires started by cigarettes into account, the total cost to society is nearly £14 billion. This is far more than the government receives in cigarette taxes.

Helping people stop smoking can help our health and economy. People who stop smoking can reduce their risk of getting a smoking-related disease surprisingly quickly. Even if you already have a condition caused by smoking, such as COPD, giving up is the most effective way to stop your lungs getting any worse (even though the damage already done won’t recover completely). This in turn will reduce pressure on the NHS and on society as a whole.

So can e-cigarettes help you stop smoking? Well, we know e-cigarettes have already helped many people quit. There is growing evidence that they are as effective, or even more effective, than other nicotine replacement products like gum and patches.

It is true there is a lot of ‘dual use’, which means people using e-cigarettes without actually fully stopping smoking. Some people have also suggested that e-cigarettes may act as a ‘gateway’ for people to start smoking in the first place (although the fact that smoking rates have continued to fall while vaping has become more common suggests there is no reason for these concerns).

E-cigarettes also haven’t been popular for very long, so we don’t know everything about them yet. We need lots more research to fully understand their long-term health impact, whether they help people to quit for good or just a little while, and what they do to people who already have a lung disease.

However, all the evidence we do have suggests is that vaping is at least 95% less harmful than smoking. That gives them huge potential to help protect the health of the nation. And while we wouldn’t recommend vaping to non-smokers, if you are a smoker who hasn’t yet managed to quit using other methods – including using your local stop smoking service (the most effective way of quitting) – then you may want to consider trying e-cigarettes. This should be done with the longer term aim of eventually quitting vaping too, at least until more research has been carried out.

I was recently asked what people will be saying in 30 years about e-cigarettes. Though impossible to answer for sure, what I hope is that they’ll be pleased organisations like the British Lung Foundation encouraged the right research to establish the benefits and risks of e-cigarettes, and that we really understand the pros and cons of vaping as a result.

Wouldn’t it be wonderful if people were saying that e-cigarettes helped the UK become a smoke-free nation? Only time will tell whether they will.

Dr Penny Woods
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