When I tell anyone I research e-cigarettes, they almost always come with an opinion about them. A few will be vapers themselves, and those that are almost without fail sing the praises of the device that finally helped them quit smoking. But often people who’ve never tried e-cigarettes will focus on the potential risks from using them, particularly whether they’re prone to reintroduce smoking to a young generation who have been steadily shunning it in bigger numbers over recent decades. A certain fear is that young adults will test out e-cigarettes and that this can be a gateway in to smoking, in addition to fears around the harms from e-cigarettes themselves.
A newly released detailed study of over 60,000 UK 11-16 year olds has found that young people who experiment with e-cigarettes are generally those who already smoke cigarettes, and also then experimentation mostly doesn’t translate to regular use. Not only that, but smoking rates among younger people throughout the uk remain declining. Studies conducted to date investigating the gateway hypothesis that vaping leads to smoking have tended to check out whether having ever tried an electronic cigarette predicts later smoking. But young adults who test out e-cigarettes will be distinctive from those who don’t in plenty of alternative methods – maybe they’re just more keen to adopt risks, which would also boost the likelihood that they’d try out cigarettes too, no matter whether they’d used e-cigarettes.
Although there are a small minority of young people that do commence to use best e cigs on the market without previously becoming a smoker, as yet there’s little evidence that this then increases the chance of them becoming cigarette smokers. Increase this reports from Public Health England which have concluded e-cigarettes are 95% safer than smoking, and you might think that could be the conclusion in the fear surrounding them.
But e-cigarettes have really divided the general public health community, with researchers who have the normal goal of decreasing the degrees of smoking and smoking-related harm suddenly finding themselves on opposite sides of the debate. This is concerning, and partly because in a relative dearth of research on the devices the same findings are used by both sides to aid and criticise e-cigarettes. And all of this disagreement is playing out in the media, meaning an unclear picture of the things we know (and don’t know) about e-cigarettes will be portrayed, with vapers feeling persecuted and people who have not yet tried to quit mistakenly believing that there’s no reason for switching, as e-cigarettes might be equally as harmful as smoking.
An unexpected results of this may be that it makes it harder to perform the particular research necessary to elucidate longer-term outcomes of e-cigarettes. And this is something we’re experiencing since we try and recruit for your 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 proven that smokers use a distinct methylation profile, compared to non-smokers, and it’s possible that these modifications in methylation might be linked to the increased chance of harm from smoking – for instance cancer risk. Even when the methylation changes don’t make the increased risk, they may be a marker of this. We wish to compare the patterns seen in smokers and non-smokers with those of electronic cigarette users, potentially giving us some insight into the long term impact of vaping, while not having to wait for time to elapse. Methylation changes happen relatively quickly than the start of chronic illnesses.
Part of the difficulty using this is the fact that we know that smokers and ex-smokers have a distinct methylation pattern, and that we don’t want this clouding any pattern from vaping, meaning we have to recruit vapers who’ve never (or certainly only hardly ever) smoked. And also this is proving challenging for just two reasons. Firstly, as borne out by the recent research, it’s unusual for people who’ve never smoked cigarettes to adopt up regular vaping. Yes, maybe they’ll experiment, but that doesn’t necessarily cause an electronic cigarette habit.
But in addition to that, an unexpected problem has been the unwillingness of some within the vaping community to assist us recruit. And they’re postpone because of fears that whatever we find, the final results will be employed to paint a negative picture of vaping, and vapers, by people with an agenda to push. I don’t desire to downplay the extreme helpfulness of lots of people inside the vaping community in helping us to recruit – thanks, you understand who you really are. However I really was disheartened to learn that for some, the misinformation and scaremongering around vaping has reached the point where they’re opting from the research entirely. And after speaking to people directly about this, it’s tough to criticize their reasoning. We now have also found that numerous e-cigarette retailers were resistant against putting up posters aiming cwctdr recruit people who’d never smoked, since they didn’t want to be seen to become promoting electronic cigarette use within people who’d never smoked, that is again completely understandable and really should be applauded.
Exactly what can we all do concerning this? I hope that as more scientific studies are conducted, and we get clearer information about e-cigarettes ability to serve as a smoking cessation tool, the disagreement around them will disappear. Until then, Hopefully vapers still agree to participate in research so we can fully explore the chance of these units, 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, when compared with smoking.