Whenever I tell anyone I research e-cigarettes, they almost always have an opinion about them. Some will be vapers themselves, and people who 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, especially whether they’re very likely to reintroduce smoking to a young generation who have 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 will 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 has found that young adults who test out e-cigarettes are often those that already smoke cigarettes, as well as then experimentation mostly doesn’t translate to regular use. In addition to that, but smoking rates among young people in the UK are still declining. Studies conducted currently investigating the gateway hypothesis that vaping contributes to smoking have tended to consider whether having ever tried an e-cigarette predicts later smoking. But young people who experiment with e-cigarettes will probably be different from those that don’t in a lot of alternative methods – maybe they’re just more keen to take risks, which would also raise the likelihood that they’d test out cigarettes too, whether or not they’d used e-cigarettes.
Although you will find a small minority of younger people that do start to use best e cigarettes without previously becoming a smoker, as yet there’s little evidence this then increases the chance of them becoming cigarette smokers. Enhance this reports from Public Health England which have concluded e-cigarettes are 95% safer than smoking, and you will think that would be the end in the fear surrounding them.
But e-cigarettes have really divided the general public health community, with researchers that have the most popular aim of reducing the amounts of smoking and smoking-related harm suddenly finding themselves on opposite sides of the debate. This really is concerning, and partly because in a relative dearth of research on the devices the identical findings are used by both sides to back up and criticise e-cigarettes. And all of this disagreement is playing out in the media, meaning an unclear picture of the things we realize (and don’t know) about e-cigarettes has been portrayed, with vapers feeling persecuted and those that have not yet tried to quit mistakenly believing that there’s no reason for switching, as e-cigarettes may be just like harmful as smoking.
An unexpected consequence of this might be it causes it to be harder to do the particular research necessary to elucidate longer-term outcomes of e-cigarettes. And this is something we’re experiencing while we try and recruit for the current study. We have been performing a research project funded by CRUK, where we’re collecting saliva samples from smokers, vapers and non-smokers. We’re checking out DNA methylation, a biological marker that influences gene expression. It’s been shown that smokers use a distinct methylation profile, when compared with non-smokers, and it’s likely that these modifications in methylation may be linked to the increased probability of harm from smoking – for instance cancer risk. Even if the methylation changes don’t cause the increased risk, they may be a marker of this. We would like to compare the patterns observed in smokers and non-smokers with the ones from e-cigarette users, potentially giving us some insight in the long-term impact of vaping, without needing to watch for time to elapse. Methylation changes happen relatively quickly when compared to the beginning of chronic illnesses.
Area of the difficulty with this particular is that we understand that smokers and ex-smokers have a distinct methylation pattern, and that we don’t want this clouding any pattern from vaping, meaning we need to recruit vapers who’ve never (or certainly only hardly ever) smoked. And this is proving challenging for just two reasons. Firstly, as borne out by the recent research, it’s very rare for individuals who’ve never smoked cigarettes to take up regular vaping. Yes, maybe they’ll experiment, but that doesn’t necessarily result in an electronic cigarette habit.
But on top of that, an unexpected problem has been the unwillingness of some within the vaping community to aid us recruit. And they’re postpone due to fears that whatever we find, the outcomes will be employed to paint a poor picture of vaping, and vapers, by people with an agenda to push. I don’t want to downplay the extreme helpfulness of lots of people in the vaping community in assisting us to recruit – thanks a lot, you understand who you are. But I was really disheartened to learn that for a few, the misinformation and scaremongering around vaping has reached the point where they’re opting out of the research entirely. And after speaking to people directly concerning this, it’s hard to criticize their reasoning. We now have also discovered that several e-cigarette retailers were resistant against setting up posters aiming cwctdr recruit people who’d never smoked, since they didn’t wish to be seen to be promoting e-cigarette use within people who’d never smoked, that is again completely understandable and should be applauded.
What can we all do concerning this? I hope that as increasing numbers of scientific studies are conducted, and that we get clearer information on e-cigarettes ability to work as a smoking cessation tool, the disagreement around them will disappear. Until then, I hope that vapers still agree to take part in research so that we can fully explore the chance of these devices, particularly those rare “unicorns” who vape but have never smoked, as they may be important to helping us be aware of the impact of vaping, as compared to smoking.