7 Things You Need To Know About Vaping

Jamie Hartmann-Boyce from the Cochrane Tobacco Addiction Group has shared 7 things you need to know about e-cigarettes and vaping.

Jamie Hartmann-Boyce from the Cochrane Tobacco Addiction Group and Martin Dockrell from the Office of Health Improvement and Disparities (OHID) have shared 7 things you need to know about e-cigarettes and quitting smoking, with evidence from the Cochrane Living Review of E-cigarettes and Smoking Cessation.

Associate Professor Dr Jamie Hartmann-Boyce has conducted many independent UK studies looking at vaping and e-cigarettes and is acknowledged to be an expert in the field. Martin Dockrell was the lead for tobacco control at Public Health England and continues to deliver enthusiastic evidenced-based support for UK e-liquids and vapes in his new role at the OHID.

They describe the living review work done at Cochrane as bringing together “the best available research evidence to examine the effectiveness, tolerability, and safety of using electronic cigarettes to help people who smoke tobacco achieve long‐term smoking abstinence.”

They say there are seven key things to take away from the latest paper released by Cochrane Reviews.

Quitting cigarettes even for a few days can benefit your health

• Within days your heart rate will drop and carbon monoxide and oxygen levels in your blood will return to normal levels.
• After 1 to 9 months and coughing and shortness of breath will decrease.
• After 1 year your risk of heart attack will have halved compared to someone who smokes.

Willpower is important, but it is rarely enough

• In England today there are twice as many ex-smokers as current smokers but that does not mean that quitting is always easy.
• Most smokers have to make repeated attempts and there is no one way that works for everyone the first time.
• “Will power alone” provides the baseline on which better interventions can build.

Combine different types of support for the best quit rates

• People are more likely to successfully quit if they use evidence-based stop-smoking treatment, such as behavioural counselling, stop-smoking medication, and/or e-cigarettes with nicotine. Using both behavioural support and stop-smoking medication increases quit rates more than using either alone.

E-cigarettes are an effective tool to help people stop smoking

• Evidence shows that head to head, e-cigarettes with nicotine are more effective than nicotine replacement therapy or using e-liquids without nicotine (short fills) in helping people quit smoking.
• In England, e-cigarettes are more popular than nicotine replacement therapy (patches and gum) as a quitting tool.
• NICE (National Institute for Health and Care Excellence) guidelines advise people who provide stop-smoking support to offer advice on using nicotine-containing products on general sale, including over-the-counter nicotine replacement therapy and nicotine-containing e-cigarettes.
• People who use e-cigarettes to quit smoking may use them longer than if they were to use other treatments, like nicotine patches. This may be one reason that they are more effective. Approximately half of the people using e-cigarettes to stop smoking are still using e-cigarettes at 6 months. Among people successfully using e-cigarettes to stop smoking 70% continued to use e-cigarettes at 6 months.

People who switch from smoking to vaping are likely to improve their health

• Switching from combustible cigarettes to e-cigarettes reduces levels of toxicants in the blood and breath.
• E-Cigs do not burn tobacco and do not produce tar or carbon monoxide, two of the most damaging constituents of tobacco smoke.
• E-cigarettes heat a liquid that usually contains nicotine, propylene glycol and/or vegetable glycerine and flavourings.
• We still need data on the long-term use of e-cigarettes, however, expert consensus is that, though not risk-free, e-cigarettes are considerably safer than combustible cigarettes.

Misplaced fears about EC safety may be putting smokers off switching

• Despite a growing body of evidence suggesting e-cigarettes are less harmful than smoking, risk perceptions are going in the opposite direction.
• A rare but serious lung condition associated with vaping (EVALI) received a lot of media attention. This led people to be more concerned about the risks of using e-cigarettes (Tatton Birch’s paper on EVALI and EC risk perception). However, this condition was later linked to vitamin e acetate, an additive found in non-regulated e-cigarettes containing THC (the active ingredient in marijuana) in North America. Vitamin e acetate is banned from e-cigarettes in the UK and Europe, and there have been no cases of EVALI in the UK.
• Smokers from less advantaged backgrounds may be more likely to have misperceptions of the relative harm. People from less advantaged backgrounds are more likely to smoke and more likely to find it harder to quit, and so are some of the people who would benefit most from trying to use e-cigarettes to quit smoking.

Cigarette use is reducing across the world. The UK is one of the countries aiming to become smoke-free by 2030

• Across the world, the prevalence of combustible cigarette smoking is 17.5%. This has dropped from 23% 15 years ago. (WHO, 2021). In the UK the prevalence of combustible cigarette smoking is 14%. More than half of people in the UK who currently smoke said they would like to quit.
• Many countries are moving towards smoke free goals. The UK aims to be smoke free by 2030.