Thousands of cigarette smokers have been able to quit in the UK by switching to e-cigarettes, also known as vapes, claims a new study published in the journal Addiction. There appears to be positive correlation between the use of e-cigarettes by people attempting to quit, from 2011, and the number of successful quitters. Similarly, with a plateau in vaping being reached around the year 2015, successful quitting attempts also flattened out.
The researchers conclude that at least an estimated 50,000 to 70,000 smokers were able to quit, and thus benefited from the use of e-cigarettes to quit in 2017. On the other hand, about 3 million people are estimated to use e-cigarettes each year in the UK, as compared to 6 million cigarette smokers, so most vapers aren’t really giving up smoking, or so it would appear. According to one study, almost 60% of vapers also smoke cigarettes, about 2-5 a day, while ex-smokers continue to vape 6-plus times a day.
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Smoking – the health costs
Smoking is the No. 1 preventable cause of cancer and cancer-related deaths in the UK, according to Cancer Research UK, accounting for 70% of lung cancers, as well as being linked to cancers of the mouth and throat, larynx, nose and paranasal sinuses, and many parts of the digestive tract from the esophagus, through the pancreas, to the intestines. It is also associated with kidney, bladder, ovary, and cervical cancer, as well as certain types of leukemia. Smoking is also the cause of serious and chronic progressive lung disease and heart disease.
Smoking releases about 4,000 chemicals, of which at least 250 are toxic, and 50 are linked to cancer. Smoking causes DNA damage, inhibits DNA repair mechanisms, and promotes the toxic effects of other harmful chemicals on DNA. Smoking also inhibits normal ciliary action within the airways, which are responsible for clearing toxic chemicals from the lungs. Smoking costs the smoker about 540 pounds a year in the UK, on average.
Not only do smokers put themselves at higher risk for multiple health issues, but they also put others at risk. For instance, passive smoking causes lung cancer, larynx cancer and throat cancer as well as chronic lung disease, even though the victim has never smoked. Second-hand smoking is especially hazardous to children, and unfortunately, most exposure to second-hand smoke happens at home. Children exposed to tobacco smoke can develop asthma, bacterial meningitis, colds and chest infections, and sudden infant death syndrome (SIDS) at higher rates than non-exposed children.
Quitting smoking is therefore a high health priority for smokers, since the duration of smoking is the factor most closely associated with cancer risk, in combination with the number of cigarettes smoked.
The study and its findings
The data used for this study came from the Smoking Toolkit Study, which is a set of surveys covering a cross-section household surveys of individuals 16 years or older at the time of the survey, dating from 2006 onwards. The information was obtained from about 1,200 people each quarter, who admitted to smoking over the last year, for a total of over 50,000 between 2006 and 2017. The analysis of the data from the time series looked at whether the current use of e-cigarettes as well as their use while trying to quit was associated with the number of attempts to quit, the overall quit rate, the rate of success and the number of cigarettes smoked on average. The researchers adjusted for the season-linked changes in smoking, broader population trends, smoking-related policies, tobacco advertisement expenditure, and the price of tobacco at current levels.
The researchers found that in the UK, e-cigarettes were marketed with far tighter control than in many other countries. As a result, people who had never smoked did not typically take to e-cigarettes at any age, while smokers who are trying to quit use these devices to reduce their consumption or to stop cigarettes altogether.
Researcher Emma Beard says, “England seems to have found a sensible balance between regulation and promotion of e-cigarettes.”
The results, they say, agree with other data from population-level surveys and clinical trials that actually support the use of e-cigarettes to help smokers to quit. These devices do not use tobacco though they do contain nicotine, which is heated to vaporization, allowing the smoker to inhale it just as from a regular cigarette. The difference is in the level of nicotine, which is typically lower than that found in cigarette smoke, and is comparable to that found in nicotine patches or gum, products often recommended for smokers who want to quit. The rationale for e-cigarette use by wanna-quitters is to provide enough nicotine to satisfy the craving but avoid the other toxic chemicals in tobacco smoke, besides allowing the smoker to feel the satisfaction of holding a smoking device and breathing in the fumes.
Cancer Research UK’s George Butterworth adds: “E-cigarettes are a relatively new product, they aren't risk free and we don't yet know their long-term impact. We strongly discourage non-smokers from using them. But research so far shows that vaping is less harmful than smoking tobacco and can help people to stop smoking, so it's good that over 50,000 people managed to give up in 2017. For the best chance of quitting, get support from a Stop Smoking Service, who can help you.”
The current report is bound to be viewed against the grim picture in the US, however, where vaping is being actively discouraged after almost 1,300 cases of acute severe lung injury and 26 deaths so far, mostly in young people who were vaping. Nonetheless, the fact remains that the regulatory scene in the UK and the US are quite different, with e-cigarette manufacture and marketing being stringently controlled in the UK.
Beard, E., West, R., Michie, S., and Brown, J. ( 2019) Association of prevalence of electronic cigarette use with smoking cessation and cigarette consumption in England: a time series analysis between 2006 and 2017. Addiction, https://doi.org/10.1111/add.14851, https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14851