America is currently in the midst of moral panic. A cluster of people have developed severe and sudden lung injuries after vaping and at least 5 deaths have now been linked to e-cigarette use. It’s important to state from the outset that this should not worry UK vapers or indeed the overwhelming majority of people around the world who use e-cigarettes as a reduced-risk smoking cessation aid.
Following these reports, the U.S Centre for Disease Control quickly stoked fears by recommending that the public “consider not using e-cigarette products.” This message is being enthusiastically spread by UK media outlets.
However, the risks for UK vapers are—unsurprisingly to those familiar with often woeful media reporting on e-cigarettes—extremely low. While these unfortunate deaths and lung injuries cannot yet be traced to one underlying cause, all indications point towards unregulated e-liquids containing THC (the psychoactive ingredient in cannabis). No such cases have ever been reported in the UK, perhaps down to the competence of our regulator (the MHRA). These deaths are clearly unrelated to vaping in general. Even if they were related, they would be comprehensively outweighed on a public health level by the millions of people in the US and UK using e-cigarettes as an especially effective way of quitting smoking. But don’t just take my word for it; various public health experts in the UK have weighed in on the controversy.
Prof Paul Aveyard, Professor of Behavioural Medicine at the University of Oxford, said:
People who vape will be asking themselves if it’s safe to vape. They can be reassured by other data we have. The best data on the effectiveness, tolerability, and safety of e-cigarettes comes from randomised trials and the largest of these was published recently, also in the New England Journal of Medicine. This trial enrolled 886 people and half tried to stop smoking by vaping and half by using nicotine replacement treatment. Most of those who stopped smoking by vaping continued using the e-cigarette for the whole year, but most of those using nicotine replacement stopped using it. At the end of that year the scientists found that people who were vaping had less cough, and produced less phlegm than those who were not vaping, while there was no difference in wheeze or breathlessness. This study added to other good quality studies that show no evidence that vaping causes short-term serious harms.
We must also remember that for nearly every person who vapes, the alternative to vaping is smoking. While vaping does produce some toxins, those are at significantly lower levels than seen in cigarette smoke. If vaping typically caused severe lung damage, we’d have seen many more cases in people who smoke, which we have not. These cases are worrying and need investigating, but advice from all official bodies in the UK is that it is always preferable to vape than to smoke.
Dr Sarah Jackson, Senior Research Fellow, UCL Tobacco and Alcohol Research Group, University College London (UCL), said:
The recent cluster of vapers developing lung problems follows a decade of widespread e-cigarette use without reports of similar adverse effects. The majority of cases appear to have been vaping illicit e-liquids containing THC. E-cigarettes are the most popular quitting aid used by smokers – and among the most effective. Advice to discourage people from vaping legal, regulated e-liquids appears to be unwarranted and risks pushing people back to smoking.
Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:
The mystery seems to have been resolved now, with cases being traced to a contaminated marijuana extract. Although the scare is being used to put smokers off switching from cigarettes to much less risky vaping, it has nothing to do with e-cigarettes as they are normally used in this country.
E-cigarettes have been around for over a decade now and are used by millions of people, with no such cases occurring. The outbreak is similar to methanol poisonings that kill people every now and then when contaminated alcohol is sold.
Aside from overzealous American regulators, the UK’s groundbreaking success in embracing tobacco harm reduction is likely to come under further pressure from the World Health Organization. Leaked documents have revealed plans for a renewed international offensive against adult smokers switching to products that are less likely to kill them. While an absolute ban on reduced-risk nicotine products appears to be their end goal, the WHO expects vaping to be treated at least as harshly as smoking in regulatory terms.
It is vital that the UK resists such pressure and fights back on the international stage. There’s reason for optimism: Public Health England’s media response to the American vaping scare has been exemplary. I’m currently planning an ASI research paper on the ways we can continue to be a world-leader in tobacco harm reduction, for example by creating a list of generic approved health statements that can be used in the marketing of regulated e-cigarette products (something Health Canada is currently in the latter stages of devising). But above all, we must not bow to ill-informed scaremongering about innovative ways to help smokers quit if they want to.