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Vaping: does it have the potential to renormalise smoking?

Edmund Stubbs, 20 August 2015

It is exciting and unusual to hear the words ‘game changer’ applied by public health professionals to anything to do with smoking. However such words were used by Professor Ann McNeill of King’s College London in Public Health England’s latest report on the practice of vaping (the smoking of e-cigarettes).

Now that the UK’s public health body has formally recognised the potential of e-cigarettes to reduce the harm associated with tobacco smoking, especially for those who cannot or do not wish to totally kick their habit, it seems that action can now be taken to enable the NHS to include e-cigarettes amongst their arsenal of smoking prevention resources. E-cigarettes can counter nicotine addiction if users so wish, as concentrations of nicotine in the replacement fluid can be gradually reduced.

However, it is surely wise to remain wary of vaping. Having rapidly gained popularity over the past ten years e-cigarettes are still novel, and, although evidence is now being presented regarding the far lower levels of free radical toxins and other harmful substances inhaled by vaping than by smoking, we must remember that in years gone by tobacco itself was even considered healthy; and smoking sometimes recommended by doctors. In fact, recent tests with mice have revealed that e-cigarette fumes can cause mild lung damage and increase susceptibility to respiratory infections.

What many medical bodies including the BMA worry about is that if vaping is seen by the public as being completely harmless, and if it is consequently marketed to emphasise its innocence, it could lead to those who do not currently smoke or vape starting to use e-cigarettes. Children are considered especially vulnerable.

As vaping, unlike smoking, is currently permitted in many indoor spaces, and the amount of vapour inhaled cannot be as easily measured as with individual tobacco cigarettes, there is the potential for people to vape more often or for longer than they would previously have smoked.

In Public Health England’s report on the practice, we learn that vaping apparently does 95 per cent less harm than does tobacco smoking; vital, perhaps life saving information for the people of England, 44.8 per cent of whom are currently unaware that e-cigarettes are better for their health.

However, it might be more effective to present this statistic the other way round: that vaping does only 5 per cent the harm of smoking. In this way we would engage current smokers, already aware that they are harming their health, and encourage them to give up tobacco, rather than inadvertently promoting a new habit of vaping in the general population.

To get an item approved as a commercial product is much easier than to gain its approval for medical purposes. Presently, many are anxious to get medical approval for e-cigarettes. Following this review there are hopes of fast tracking such devices through the Medicines and Healthcare Regulatory Agency’s vetting procedures. Although caution in approval remains advisable, some haste seems appropriate as there are currently over 270 deaths per day in the UK attributable to the effects of tobacco smoking.

Nothing comes close to how damaging smoking tobacco is for our health. Perhaps, in this case therefore, there should be less, not more, anxiety over the approval of e-cigarettes for medical use. Nevertheless, it will be a strange occurrence when the 21st century’s first medically approved cigarette appears on our shelves, albeit an electronic one.

In short, it ought to be recognised that vaping is, as Public Health England claim, far better for us than smoking, and e-cigarettes should be employed to help those wishing to stop smoking. However, at the same time vaping must not simply be regarded as a harmless leisure activity. Current evidence shows this not to be the case, and thus we must not inadvertently encourage the normality of smoking-type behaviour by the uncritical acceptance of vaping.

Edmund Stubbs is Healthcare Researcher at Civitas, @edmundstubbs1

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