Whenever I tell anyone I research e-cigarettes, they almost always come with an opinion about them. A few will be vapers themselves, and people who are almost without fail sing the praises of the device that finally helped them give up smoking. But often people who’ve never tried e-cigarettes will focus on the potential risks from using them, especially whether they’re likely to reintroduce smoking to a young generation who’ve been steadily shunning it in bigger numbers over recent decades. A specific fear is that younger people will try out e-cigarettes and that this can be a gateway in to smoking, along with fears around the harms from e-cigarettes themselves.
A newly released detailed study of more than 60,000 UK 11-16 year olds found that younger people who try out e-cigarettes are usually those that already smoke cigarettes, and even then experimentation mostly doesn’t translate to regular use. In addition to that, but smoking rates among younger people in the united kingdom remain declining. Studies conducted currently investigating the gateway hypothesis that vaping results in smoking have tended to look at whether having ever tried an electronic cigarette predicts later smoking. But young adults who experiment with e-cigarettes will be distinctive from people who don’t in lots of different ways – maybe they’re just more keen to consider risks, which would also increase the likelihood that they’d experiment with cigarettes too, regardless of whether they’d used e-cigarettes.
Although there are a small minority of young adults who do begin to use best e cigarette without previously being a smoker, as yet there’s little evidence that the then increases the chance of them becoming cigarette smokers. Add to this reports from Public Health England who have concluded e-cigarettes are 95% safer than smoking, and you will think that would be the final in the fear surrounding them.
But e-cigarettes have really divided the general public health community, with researchers that have the most popular goal of decreasing the levels of smoking and smoking-related harm suddenly finding themselves on opposite sides from the debate. This can be concerning, and partly because in a relative dearth of research on the devices exactly the same findings are employed by each side to aid and criticise e-cigarettes. And all of this disagreement is playing out in the media, meaning an unclear picture of what we realize (and don’t know) about e-cigarettes has been portrayed, with vapers feeling persecuted and people who have not even made an effort to quit mistakenly believing that there’s no point in switching, as e-cigarettes could be just as harmful as smoking.
An unexpected consequence of this may be that it can make it harder to perform the very research necessary to elucidate longer-term outcomes of e-cigarettes. And also this is one thing we’re experiencing as we attempt to recruit for our current study. We have been conducting a research project funded by CRUK, where we’re collecting saliva samples from smokers, vapers and non-smokers. We’re looking at DNA methylation, a biological marker that influences gene expression. It’s been demonstrated that smokers have a distinct methylation profile, compared to non-smokers, and it’s probable that these modifications in methylation may be connected to the increased risk of harm from smoking – for example cancer risk. Even if the methylation changes don’t cause the increased risk, they might be a marker from it. We wish to compare the patterns seen in smokers and non-smokers with the ones from electronic cigarette users, potentially giving us some insight in to the long-term impact of vaping, without needing to wait for time to elapse. Methylation changes happen relatively quickly as compared to the onset of chronic illnesses.
Area of the difficulty using this is the fact we realize that smokers and ex-smokers use a distinct methylation pattern, and that we don’t want this clouding any pattern from vaping, which suggests we must recruit vapers who’ve never (or certainly only very rarely) smoked. Which is proving challenging for just two reasons. Firstly, as borne out through the recent research, it’s very rare for individuals who’ve never smoked cigarettes to adopt up regular vaping. Yes, maybe they’ll experiment, but that doesn’t necessarily lead to an electronic cigarette habit.
But on top of that, an unexpected problem has been the unwillingness of some in the vaping community to help us recruit. And they’re put off as a result of fears that whatever we discover, the outcomes will be used to paint a negative picture of vaping, and vapers, by people who have an agenda to push. I don’t want to downplay the extreme helpfulness of lots of people inside the vaping community in assisting us to recruit – thank you, you understand who you are. But I really was disheartened to learn that for some, the misinformation and scaremongering around vaping has reached the stage where they’re opting out of the research entirely. And after talking with people directly about this, it’s difficult to criticize their reasoning. We have also found that several e-cigarette retailers were resistant to placing posters aiming cwctdr recruit people who’d never smoked, as they didn’t wish to be seen to be promoting electronic cigarette use in people who’d never smoked, that is again completely understandable and should be applauded.
Exactly what can we do about this? I hope that as increasing numbers of scientific studies are conducted, so we get clearer info on e-cigarettes ability to act as a quitting smoking tool, the disagreement around them will disappear. Until then, Hopefully vapers still agree to take part in research therefore we can fully explore the chance of these products, specifically those rare “unicorns” who vape but have never smoked, as they might be essential to helping us be aware of the impact of vaping, as compared to smoking.