PHE Addresses 'False Fears' About e-Cigarette Safety 

Nicky Broyd

March 04, 2020

A report from Public Health England (PHE) finds a growing number of adults wrongly believe vaping is more harmful than smoking. E-cigarettes and vaping: policy, regulation and guidance , is the 6th independent e-cigarette report produced by PHE and was compiled by researchers at King's College London.

It found a number of vaping-related deaths in the US, which involved substances banned in the UK, is one reason for the change in perception about the safety of vaping.

It also warns that banning flavoured vaping liquids could deter smokers from switching to e-cigarettes.

Recommendations in the report include:

  • Better enforcement of proof of age at point of sale to protect young people

  • Health professionals should use advice on using e-cigarettes during pregnancy

  • More research is needed into vaping for smokers with mental health conditions and pregnant smokers

  • More research is needed into e-cigarette flavour among young people

Safety Fears

Director of Health Improvement at PHE, Professor John Newton, said in a statement: "It is concerning to see how much the US lung disease outbreak has affected smokers’ views on e-cigarettes here in the UK. Safety fears may well be deterring many smokers from switching, leaving them on a path to years of ill health and an early death due to their smoking. The US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping liquid, was a primary cause of the US outbreak. This substance is banned in UK-regulated nicotine vaping products."

PHE has also produced new guidance for NHS mental health organisations stating: "In England, 1 in 3 cigarettes is smoked by a person with a mental health condition, so supporting them to stop smoking must be the overriding priority."

Contradictory Reports

PHE has not changed its advice, which remains that smokers should switch to e-cigarettes to help them quit smoking, but non-smokers should not take up vaping.

The National Institute for Health and Care Excellence’s (NICE) smoking cessation guidance says healthcare professionals should not discourage the use of e-cigarettes as an aid for quitting smoking.

Report lead author, Ann McNeill, professor of tobacco addiction at King’s College London, said in a news release: "It is currently very hard for smokers to make sense of the many contradictory reports on the impacts of vaping and smoking. In our review we present evidence that suggests in England, vaping has not undermined declines in adult smoking, and for youth, vaping is mainly concentrated in those who were already dabbling in cigarette smoking. However, we need to remain vigilant and ensure that vaping products, alongside regular cigarettes, are not easily accessible to young people."

England's Chief Medical Officer, Professor Chris Whitty, added: "This report is a further welcome contribution to building the evidence around an important area of public policy and highlights the challenge of maximising the opportunities."

PHE has commissioned a full evidence review into e-cigarette safety, due for publication in 2022.

New Figures 'Disturbing'

Experts have commented on the report via the Science Media Centre.

Jamie Brown, professor of behavioural science & health at University College London, said: "This report should reassure smokers whose views on the relative harm of e-cigarettes have clearly deteriorated over the last year.

"The proportion of smokers who do not currently use e-cigarettes and believe use is less harmful than smoking has fallen to less than a third, while more than half believe e-cigarettes to be equally or more harmful than smoking. One source for these figures is the Cancer Research UK funded Smoking Toolkit Study, which is a nationally representative survey of the population in England that has been recruiting a new sample of approximately 1700 adults each month since 2006."

Prof John Britton, director of the UK Centre for Tobacco & Alcohol Studies and Consultant in Respiratory Medicine, University of Nottingham, said: "These new figures from PHE are disturbing, and highlight the urgent need for media campaigns to make sure that all smokers understand that switching to e-cigarettes is one of the most effective ways of quitting smoking and protecting their health."

COIs:
Prof Britton: none
Prof Brown is a co-PI on the CRUK programme grant that supports the Smoking Toolkit Study in England and has received unrestricted research funding from Pfizer to study smoking cessation.

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