The fear that e-cigarettes will lead young people to smoking has been found to be unsubstantiated, says the largest study in the United Kingdom on the issue.
In a report published in the International Journal of Research and Public Health, researchers found that of the 60,000 young people aged 11 to 16 surveyed over the course of 2015 to 2017, only 3% or less used them regularly. But these young people were mostly already tobacco smokers
The study, the biggest of its kind so far in the UK, found that among young people who have never smoked, regular use of e-cigarettes was negligible, at between 0.1% and 0.5%.
The findings have, to some extent, assuaged concerns over the attraction of e-cigarettes for youths which might lead them to traditional tobacco smoking. It now seems that this fear is unfounded.
“This pattern was consistent across different surveys from around the UK and suggests that, for now, experimentation with e-cigarettes does not necessarily translate into regular use, particularly among never smokers,” say the researchers.
Lead author Linda Bauld, professor of health policy at the University of Stirling, said:
“Recent studies have generated alarming headlines that e-cigarettes are leading to smoking. Our analysis of the latest surveys from all parts of the United Kingdom, involving thousands of teenagers shows clearly that for those teens who don’t smoke, e-cig experimentation is simply not translating into regular use.
“Our study also shows that smoking rates in young people are continuing to decline. Future studies on this subject need to continue to monitor both experimentation and regular use of e-cigarettes and take into account trends in tobacco use if we are to provide the public with accurate information.”
The use of e-cigarettes, also known as vaping, and other alternative nicotine delivery products (including heated tobacco cigarettes), is claimed to be less harmful than the smoking of traditional, combustible cigarettes.
A recent study by Public Health England, a department in the Ministry of Health in England, found that the harm from e-cigarettes was not more than 5% of that associated with regular tobacco cigarette smoking. The Royal College of Physician concurred with the results.
E-cigarettes and these relatively new nicotine delivery products have thus been promoted in some countries as a harm-reduction alternative for smokers.
While acknowledging that the use of such products is not risk-free to users, authorities in the UK nevertheless also recognise the benefits they present to tobacco smokers, while protecting and preventing the young from using such products.
Martin Dockrell, tobacco policy manager at Public Health England, said that the study suggested the UK was broadly getting the balance right in the protection of children.
“We have a regulatory system that aims to protect children and young people while ensuring adult smokers have access to safer nicotine products that can help them stop smoking,” he said. “This includes a minimum age of sale, tight restrictions on marketing, and comprehensive quality and safety requirements. We will continue to monitor the trends in e-cigarette use alongside those in smoking.”
The study’s findings was welcome by anti-smoking campaigners, such as Action on Smoking and Health (ASH). Its Chief Executive, Deborah Arnott, said:
“ASH will continue to monitor the potential impact of e-cigarettes on young people, however this study provides reassurance that to date fears that they are a gateway into smoking are just not born out by the facts on the ground. A small proportion of young people do experiment with e-cigs, but this does not appear to be leading to regular vaping or smoking in any numbers, indeed smoking rates in young people are continuing to decline.”
Graham Moore, Deputy Director, DECIPHer, the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, said:
“Few people would argue that e-cigarette use in young people should be encouraged. However, these surveys consistently show that the rapid growth in experimentation with e-cigarettes among young people throughout the UK has so far not resulted in widespread regular use among non-smokers. Taken alongside our other recent analyses which suggest that among young people who use both e-cigarettes and tobacco, tobacco nearly always comes first, concerns that e-cigarettes are leading large numbers of young people into addiction and tobacco use increasingly seem to be implausible.”
The survey results are borne out in the number of smoking-related deaths too, since many have given up tobacco smoking after taking up vaping. The number of such fatalities have plummeted in the UK.
In July, the United States’ Food and Drugs Administration (FDA) announced that it will seek to reduce the amount of nicotine in traditional cigarettes in a bid to reduce tobacco deaths and tobacco-related disease. The FDA said some 480,000 deaths in the US are caused by smoking-related activities.
“Because nicotine lives at the core of both the problem and the solution to the question of addiction, addressing the addictive levels of nicotine in combustible cigarettes must be part of the FDA’s strategy for addressing the devastating, addiction crisis that is threatening American families,” said Scott Gottlieb, the FDA commissioner.
He also noted the potential benefits to addicted cigarette smokers of products capable of delivering nicotine without having to burn tobacco.”
“We do think there’s a potential opportunity for e-cigarettes to be a lower-risk alternative to smokers who want to quit combustible cigarettes,” Gottleib told The New York Times. “We still have to figure out if they are a way to get people off combustible cigarettes. We don’t fully understand.”