Whenever I tell anyone I research e-cigarettes, they almost always have an opinion about them. Many will be vapers themselves, and people who are almost without fail sing the praises of the device that finally helped them stop 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’ve been steadily shunning it in larger and larger numbers over recent decades. A specific fear is that younger people will test out e-cigarettes and that this will be a gateway in to smoking, along with fears around the harms from e-cigarettes themselves.
A recently available detailed study of over 60,000 UK 11-16 year olds finds that young adults who try out e-cigarettes are often those who already smoke cigarettes, as well as then experimentation mostly doesn’t translate to regular use. Not just that, but smoking rates among younger people throughout the uk continue to be declining. Studies conducted to date investigating the gateway hypothesis that vaping contributes to smoking have tended to look at whether having ever tried an electronic cigarette predicts later smoking. But young people who test out e-cigarettes will be distinct from those who don’t in lots of different ways – maybe they’re just more keen to consider risks, which will also raise the likelihood that they’d experiment with cigarettes too, no matter whether they’d used e-cigarettes.
Although there are a small minority of young adults who do start to use top rated electronic cigarette 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 who have concluded e-cigarettes are 95% safer than smoking, and you might think that might be the conclusion of the fear surrounding them.
But e-cigarettes have really divided people health community, with researchers who may have the common purpose of reducing the degrees of smoking and smoking-related harm suddenly finding themselves on opposite sides in the debate. This can be concerning, and partly because in a relative dearth of research on the devices the same findings are used by either side to support and criticise e-cigarettes. And all this disagreement is playing in the media, meaning an unclear picture of the things we understand (and don’t know) about e-cigarettes has been portrayed, with vapers feeling persecuted and those that have not even made an effort to quit mistakenly believing that there’s no part of switching, as e-cigarettes may be equally as harmful as smoking.
An unexpected results of this might be which it can make it harder to accomplish the particular research needed to elucidate longer-term outcomes of e-cigarettes. Which is something we’re experiencing since 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 taking a look at DNA methylation, a biological marker that influences gene expression. It’s been proven that smokers possess a distinct methylation profile, in comparison to non-smokers, and it’s probable that these alterations in methylation may be connected to the increased chance of harm from smoking – for instance cancer risk. Even when the methylation changes don’t result in the increased risk, they could be a marker of it. We wish to compare the patterns noticed in smokers and non-smokers with those of e-cigarette users, potentially giving us some insight in the long term impact of vaping, without having to wait around for time to elapse. Methylation changes happen relatively quickly than the onset of chronic illnesses.
Area of the difficulty using this is that we know that smokers and ex-smokers use a distinct methylation pattern, and we don’t want this clouding any pattern from vaping, meaning we have to recruit vapers who’ve never (or certainly only rarely) smoked. Which is proving challenging for 2 reasons. Firstly, as borne out by the recent research, it’s unusual for individuals 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 in the vaping community to assist us recruit. And they’re delay because of fears that whatever we discover, the outcomes will be used to paint a poor picture of vaping, and vapers, by people with an agenda to push. I don’t wish to downplay the extreme helpfulness of lots of people in the vaping community in helping us to recruit – thank you, you understand who you are. Having Said That I really was disheartened to know 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 talking with people directly concerning this, it’s difficult to criticize their reasoning. We now have also found that several e-cigarette retailers were immune to setting up posters aiming cwctdr recruit people who’d never smoked, because they didn’t wish to be seen to become promoting electronic cigarette use within people who’d never smoked, which can be again completely understandable and must be applauded.
What can we do concerning this? Hopefully as more research is conducted, and that we get clearer info on e-cigarettes capability to serve as a smoking cessation tool, the disagreement around them will disappear. Until then, Hopefully vapers continue to agree to take part in research therefore we can fully explore the potential for these products, specifically those rare “unicorns” who vape but have never smoked, as they might be crucial to helping us understand the impact of vaping, in comparison with smoking.