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 will 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 utilizing them, and in particular whether they’re likely to reintroduce smoking to a young generation who have 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, as well as fears around the harms from e-cigarettes themselves.
A newly released detailed study well over 60,000 UK 11-16 year olds found that young people who try out e-cigarettes are often those who already smoke cigarettes, and also then experimentation mostly doesn’t translate to regular use. In addition to that, but smoking rates among young adults in the UK are still declining. Studies conducted up to now investigating the gateway hypothesis that vaping contributes to smoking have tended to check out whether having ever tried an e-cigarette predicts later smoking. But younger people who test out e-cigarettes are going to be different from people who don’t in a lot of alternative methods – maybe they’re just more keen to adopt risks, which may also increase 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 e-cigarettes without previously becoming a smoker, as yet there’s little evidence this then increases the potential risk of them becoming E Cig. Add to 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 of the fear surrounding them.
But e-cigarettes have really divided the public health community, with researchers that have the most popular aim of decreasing the amounts of smoking and smoking-related harm suddenly finding themselves on opposite sides in the debate. This is concerning, and partly because in a relative dearth of research on the devices the same findings are being used by each side to aid and criticise e-cigarettes. And all sorts of this disagreement is playing in the media, meaning an unclear picture of what we understand (and don’t know) about e-cigarettes will be portrayed, with vapers feeling persecuted and those that have not even attempted to quit mistakenly believing that there’s no part of switching, as e-cigarettes might be just as harmful as smoking.
An unexpected consequence of this may be it can make it harder to perform the research needed to elucidate longer-term effects of e-cigarettes. And also this is one thing we’re experiencing while we try and recruit for our current study. We are conducting 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 shown that smokers have a distinct methylation profile, when compared with non-smokers, and it’s possible that these changes in methylation could be linked to the increased risk of harm from smoking – for example cancer risk. Even when the methylation changes don’t make the increased risk, they might be a marker of it. We want to compare the patterns noticed 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, while not having to watch for time for you to elapse. Methylation changes happen relatively quickly than the beginning of chronic illnesses.
Part of the difficulty using this is the fact we realize that smokers and ex-smokers use a distinct methylation pattern, and that we don’t want this clouding any pattern from vaping, which suggests we need to recruit vapers who’ve never (or certainly only very rarely) smoked. And also this is proving challenging for 2 reasons. Firstly, as borne out by the recent research, it’s rare for folks who’ve never smoked cigarettes to take 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 has become the unwillingness of some within the vaping community to help us recruit. And they’re postpone as a result of fears that whatever we find, the final results will be utilized to paint a negative picture of vaping, and vapers, by individuals with an agenda to push. I don’t want to downplay the extreme helpfulness of plenty of kbajyo in the vaping community in helping us to recruit – thanks a lot, you know what you are about. However I was really 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 hard to criticize their reasoning. We have now also learned that a number of electronic cigarette retailers were immune to placing posters aiming to recruit people who’d never smoked, since they didn’t wish to be seen to be promoting e-cigarette use in people who’d never smoked, which can be again completely understandable and really should be applauded.
So what can perform relating to this? I hope that as increasing numbers of research is conducted, so we get clearer info on e-cigarettes capacity to act as a smoking cessation tool, the disagreement around them will disappear. For the time being, Hopefully vapers continue to agree to take part in research so we can fully explore the potential for these devices, specifically those rare “unicorns” who vape but have never smoked, as they might be crucial to helping us comprehend the impact of vaping, in comparison with smoking.