Whenever I tell anyone I research e-cigarettes, they almost always come with an opinion about them. Many will be vapers themselves, and those 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, particularly whether they’re 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 experiment with e-cigarettes and that this will be a gateway in to smoking, along with fears around the harms from e-cigarettes themselves.
A recent detailed study of more than 60,000 UK 11-16 year olds found that young adults who try out e-cigarettes are often those that already smoke cigarettes, and also then experimentation mostly doesn’t translate to regular use. Not just that, but smoking rates among young people throughout the uk remain declining. Studies conducted currently investigating the gateway hypothesis that vaping results in smoking have tended to check out whether having ever tried an e-cigarette predicts later smoking. But young adults who experiment with e-cigarettes are going to be distinct from those who don’t in lots of other ways – maybe they’re just more keen to consider risks, which may also increase the likelihood that they’d try out cigarettes too, no matter whether they’d used e-cigarettes.
Although you can find a small minority of young people who do start to use best electronic cigarettes without previously as being a smoker, as yet there’s little evidence 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 will think that could be the end in the fear surrounding them.
But e-cigarettes have really divided the general public health community, with researchers who may have the normal goal of lowering the levels of smoking and smoking-related harm suddenly finding themselves on opposite sides from the debate. This really is concerning, and partly because in a relative dearth of research on the devices the same findings are being used by either side to back up and criticise e-cigarettes. And all of this disagreement is playing in the media, meaning an unclear picture of what we understand (and don’t know) about e-cigarettes is being portrayed, with vapers feeling persecuted and people who have not yet attempted to quit mistakenly believing that there’s no reason for switching, as e-cigarettes may be just as harmful as smoking.
An unexpected consequence of this could be which it can make it harder to do the very research necessary to elucidate longer-term effects of e-cigarettes. And also this is one thing we’re experiencing since we try to recruit for our current study. Our company is 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 demonstrated that smokers have a distinct methylation profile, compared to non-smokers, and it’s possible that these alterations in methylation may be linked to the increased chance of harm from smoking – for example cancer risk. Even when the methylation changes don’t result in the increased risk, they may be a marker of it. We want to compare the patterns observed in smokers and non-smokers with the ones from e-cigarette users, potentially giving us some insight in to the long-term impact of vaping, without needing to wait around for time to elapse. Methylation changes happen relatively quickly when compared to the onset of chronic illnesses.
Portion of the difficulty using this is the fact 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 very rarely) smoked. And also this is proving challenging for two reasons. Firstly, as borne out through the recent research, it’s rare for individuals who’ve never smoked cigarettes to consider up regular vaping. Yes, maybe they’ll experiment, but that doesn’t necessarily lead to an e-cigarette habit.
But on top of that, an unexpected problem continues to be 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 in the vaping community in aiding us to recruit – thank you, you know what you are about. But I was disheartened to know that for some, the misinformation and scaremongering around vaping has reached the stage where they’re opting from the research entirely. And after talking to people directly relating to this, it’s hard to criticize their reasoning. We have now also found that a number of 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 get promoting e-cigarette use in people who’d never smoked, which is again completely understandable and should be applauded.
What can we do concerning this? Hopefully as more research is conducted, and that we get clearer information on e-cigarettes ability to work as a smoking cessation tool, the disagreement around them will disappear. For the time being, I hope that vapers continue to agree to participate in research so that we can fully explore the potential of these devices, specifically those rare “unicorns” who vape but have never smoked, as they could be essential to helping us be aware of the impact of vaping, when compared with smoking.