Vaping is not without controversy, with lots of negative headlines in the press, particularly concerning illegal underage vaping taking place in schools. Yet, one might ask, is this really the true story?
Clearly it cannot be, since the NHS backs vaping as a means of stopping smoking. That is not to say vaping is a zero-harm option, but it is a great deal less bad for you to use liquid vapes than to fill your lungs with tar and other toxins whenever you puff on a cigarette.
That is why the government is piloting a scheme handing out free vapes to smokers to help them quit, all of which may seem to fly in the face of the headlines. Still, as the saying goes, never let the facts get in the way of a good story.
What, then, is not so much the ‘good story’ as the ‘accurate story’? How was it that it came to be so clearly established that vaping can help you quit smoking that government ministers and health service bosses back this approach?
The Weight Of Positive Evidence
The reason is that so many studies have supported the point that vaping is more effective than other means as a method of stopping smoking.
In 2021, for instance, a study of no fewer than 61 pieces of research showed this to be so. As Harvard University’s Health Department noted, this was the reason the Federal Drug Administration Service authorised three new vaping products in 2021.
UK studies have also supported vaping as a means of smoking cessation. In 2021, Public Health England’s seventh independent report on vaping in England found that using vaping as part of a strategy to quit smoking had a success rate of between 59.7 and 74 per cent in 2019 and 2020.
Critically, it noted that: “Evidence over the years suggests that as the use of vaping products in quit attempts increases, the number of successful quits in England also increases.” It estimated that in 2017 alone, 50,000 people had quit smoking who would not have done so had they not used vaping to help kick the habit.
Commenting on that study, director of health improvement at Public Health England, Professor John Newton, said: “Thousands more could have quit except for unfounded safety fears about e-cigarettes. The evidence has been clear for some time that, while not risk-free vaping is far less harmful than smoking.”
He added: “For anyone who smokes, particularly those who have already tried other methods, we strongly recommend they try vaping and stop smoking.”
Put together, this body of evidence looks very compelling. Small wonder, then, that the government is pro-vaping as a public health measure.
Anti-Vapers Argue Back
However, if you thought that this would bring universal acceptance, there is the fact that some will happily grasp at a handful of studies offering a contrary view.
For example, an article in Healthline tried to damn the pro-vaping case with faint praise, calling it “not entirely unwarranted”, while choosing to downplay the level of favourable evidence.
For example, while it mentioned that one study published in the British Medical Journal showed a clear link between smoking cessation and vaping, it managed to conveniently overlook the many others (like those mentioned above) coming to the same conclusion, while talking up a few less favourable studies.
Noting a couple of these, it pointed to a European study published in 2017 that claimed there was no evidence that vaping helped people stop smoking, contending instead that people became ‘dual users’ who would consume nicotine through both means.
Healthline also cited a more recent study by PLOS One that suggested “almost nobody” is helped to stop smoking by vaping.
The same article went on to note that a more recent study, using research on 850 individuals drawn from GfK Global’s Knowledge Panel, suggested 90 per cent of those who smoked and tried vaping to quit were still smoking a year later – although a far higher number of people had managed to quit within three months before later relapsing.
Putting 2+2 Together To Make 5
The conclusion it drew, however, was not so crude as to suggest vaping is pointless, but rather to point to the power of addiction and the need for follow-up methods to help those who have learned to quit through vaping to stay off cigarettes, perhaps with the help of extra means like behavioural therapy.
Even this is to overlook a point made in the Harvard article. It noted that the analysis of those 61 studies set the successful smoking cessation rate at between nine and 14 per 100, the lower end of which tallies with the GfK figures, but also found that alternatives such as patches and gum only had a rate of between four and seven per hundred.
Thus even if the most pessimistic interpretation of the GfK study is accepted, it still represents a better set of smoking cessation outcomes than the alternatives.
Moreover, the other part of the GfK conclusion – that the trick lies not in vaping alone to help stop smoking but a combination of this and other means for the best chances of success – tallies with the strong pro-vaping message given by Professor Newton when talking about the 2021 Public Health England report.
His recommendation that those who had unsuccessfully tried to stop smoking through other means should try vaping came with the additional advice that this should be tried “ideally with additional support from their local stop smoking service for the very best chance of quitting for good”.
How Seriously Should We Take Minority Reports?
Overall, therefore, it must be questioned just how much weight can be given to the 2017 European study and the PLOS One research. It is often the case that when there are many studies carried out on a particular topic, one or two of them produce conclusions that run contrary to the majority.
Of course, science advances when someone produces evidence that challenges received wisdom, but that does require strong evidence and many more rogue studies end up falling by the wayside, their alternative conclusions dismissed by most and often for very good reason. For every Theory of Relativity, there is a Planet X, alchemy or ether.
After all, when even the last of the studies cited by Healthline cannot produce evidence that runs particularly contrary to the findings of studies with positive conclusions about vaping, we can be confident that this really is the best way to stop smoking, used in conjunction with further support.
