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How Accurate is the Science Behind the UK’s ENDS Stance?

E-cigarettes and other vaping products (ENDS) have been declared 95% less harmful by the UK government than tobacco cigarettes. Consequently, Public Health England is of the opinion that vaping is preferable to smoking, and vaping nicotine-based e-liquids should be used as a means to quit smoking.

As a result, companies like V2 Cigs have experienced a massive explosion in growth, with smokers looking to move across from smoking to vaping.

However, the questions that beg are, where is the peer-reviewed evidence that supports these statements? And how accurate is the science behind this evidence?

The accuracy of the evidence supporting vaping is less harmful than smoking

By way of answering these questions, let’s consider the scientific research in detail.

At the outset of this discussion, it is essential to note that 95% less harmful than smoking means that the “95% less harmful is a percentage expression of vaping’s comparative toxicity relative to combustible tobacco, based on a comprehensive review of a broad range of research and studies.”

To understand what this statement means, according to the article titled “Research supports vaping as at least 95% less harmful than smoking,” we must consider the study published by the Royal College of Physicians. This research study found that all the “toxicological, clinical, and epidemiological evidence” points to the fact that the chemicals found in the “nicotine-based e-liquid vapor are well below the levels of chemicals present in cigarette smoke” from tobacco-based cigarettes.

Secondly, many studies reviewed by the Royal College of Physicians point to the fact that the physiological outcomes of vaping versus smoking are far less in vaping than smoking. Elements such as reduced blood pressure levels when vaping versus elevated blood pressure levels caused by smoking, lung function improved when vaping and decreased when smoking, and vaping produced fewer smoking-related diseases. And even though vaping nicotine-based e-liquids still allows for the ingestion of nicotine into the bloodstream, there is evidence that vaping is less addictive and produces less dependence than smoking.

Therefore, it is reasonable to conclude that vaping is much less harmful than smoking.

Supporting the fact that adult vapers are more likely to quit smoking

The accuracy of the evidence supporting the fact that adults who vape are more likely to quit using cigarettes is based on a research study titled “Association Between Electronic Cigarette Use and Smoking Reduction in France.”

The question asked by this study, “Is electronic cigarette use associated with smoking reduction in the general population,” provided the boundaries or parameters for this study. And, in summary, the study found that “among daily smokers in France, regular (daily) electronic cigarette use is associated with a significantly higher decrease in the number of cigarettes smoked per day as well as an increase in smoking cessation attempts.”

In other words, daily e-cigarette use, vaping nicotine-based e-liquids, is playing a fundamental role in helping people quit smoking if they intend to quit smoking. However, the long-term prognosis of whether ex-smokers will relapse is not absolute.

There is a caveat here that this research study found that vaping nicotine-based e-liquids amongst former smokers is sometimes associated with a relapse in that they return to smoking tobacco.

The study’s lead researcher noted that even though smokers quit smoking through the use of vaping, they still need to be monitored by a medical professional on a long-term basis to prevent a relapse. Even though this long-term medical care will carry a cost, it is far cheaper than the cost of treating smoking-related diseases.

A report titled “Smoking and the Public Purse” highlights the fact that the cost of treating smoking-related diseases averages at £2.6 billion (GBP) per annum. However, the overall societal cost of smoking-related conditions, including the economic costs, can rise to as much as £47 billion per annum. 

2019 figures show that the average annual cost per patient for medical treatment at the lower end of the scale is just under £500 per annum. Juxtapositionally, the high end of the scale shows that the top 5% of medical care costs just under £10 000 per annum.

Therefore, if we assume that the only medical care a former smoker needs is regular out-patient monitoring by a general practitioner, it should cost no more than £500 per annum. However, it will cost 20 times that amount to treat a smoking-related disease like lung cancer.

Newer vaping technology reduces the risk of relapse

It is important to note that the latest vaping technology can play a fundamental role in preventing former smokers from relapsing. Statistics show that a substantial number of people who quit smoking after 2009, was at risk of relapsing if they vaped during that time. On the other hand, smokers who quit after 2013 and vaped showed a decreased likelihood of relapsing.

Why?

An article published on CNN.com titled “Adults who vape are more likely to quit cigarettes, study finds” noted that researchers found that “measures of plasma nicotine levels have shown that, compared with older models of [e-cigarettes], the new generation delivers higher levels of nicotine to the bloodstream, which may make them more satisfying.”

In other words, the latest e-cigarettes have a much higher capacity for converting the e-liquids into a vapor-like mist, allowing for a more significant percentage of the active ingredient, in this case, nicotine, to be absorbed by the lungs into the bloodstream.

Finally, other unspecified technical improvements in e-cigarettes and vaping e-liquids may also explain why people who quit smoking and transition to vaping were less likely to relapse than people who quit smoking and used the older e-cigarette models.

It is essential to note that the earliest vaping devices bear no resemblance to current technology. This statement was made by Gregory Conley, the president of the American Vaping Association. He went on to further state, “e-cigarettes have undergone drastic changes in recent years. Prior to technological advancements made around 2013, e-cigarette devices were difficult to use and only effective for the most dedicated of would-be quitters.”

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