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Study: "To vape or not to vape?" - Results and Discussion

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Two days ago, a preliminary study, titled: "To vape or not to vape?", was released by the American Enterprise Institute. The study, meant to compare and contrast the perception and usage rates of e-cigarettes in the UK versus the US, contained some very interesting data. Expounding on that data, the authors of the study drew some conclusions that could be used as excellent guidance materials for the Federal government in the United States; it's up to them now to decide whether or not to heed their advice. Today, we're going to dig into the vape juice and e-cigarettes study and flush out some of the details. We'll include some quotes and data, and we'll provide some of our own commentary on the results. Let's get started!

To vape or not to vape?

If we can be excused to make a comment on the validity of this study, taking into account our inherent bias, we're thrilled to see that a body of intelligent, studious, physicians in the United States is looking into the differences in perception and usage rates of e-cigarettes in the UK and the US. Both countries have a significant number of smokers and e-cigarette users, but until now, it's been unclear as to how effective they've been in the two countries in helping smokers to quit. In addition, with the outpouring of support for e-cigarettes as a "far-safer" alternative to smoking from the UK government, and the lack of vocal messaging from the US government regarding their safety, it's important to see how public perception is impacted. We'll dive further into the data regarding these questions in a minute here, but it's important to first point out that the messaging is, indeed, drastically different. 

In the United Kingdom, smokers are actively encouraged to look at e-cigarettes as a method to quit smoking by their government and health professionals. In fact, during a "Quit Smoking" campaign at the end of 2018, advertisements and messaging from the UK government legitimately promoted e-cigarettes to smokers. However, in the United States, the government's messaging surrounding e-cigarettes has been almost entirely focused on youth access and use of the products. 

While it's important to note that no one, including vaping companies, want the youth of America to use vapor products, it's also important to weigh the possibility that the negative messaging surrounding vapor products from the US government may actually prolong smoker's habits and be an overall net-negative on public health. If the focus of these regulatory bodies is to encourage a healthier populace, one would think that the use of a proven-safer alternative (thanks to the Royal College of Physicians study) would also be encouraged. One would think...but that is not necessarily the case...

The first question asked of survey participants was where they purchased their smoking products. Second, they were asked if they'd ever used alternative products that might help them to quit smoking, such as patches or other cessation products. Finally, they were asked if they'd ever used alternative smoking products, such as a vaping or "heat-not-burn" tobacco product, and if yes, did it help them to quit smoking or did they continue to use regular cigarettes. 

As predicted, the difference in data from the UK and US was statistically significant. In the US, of those who had tried to quit smoking, only 21% used an alternative product, and 87.5% believed that e-cigarettes were no safer than regular cigarettes. However, in the UK, 36% of respondents used an alternative product to quit smoking, and only 23.4% believed that e-cigarettes were no safer than regular cigarettes. The difference there is staggering. Additionally, in comparison to Philadelphia and D.C., respondents in London were 69% more likely to try alternative products to quit smoking.

What did AEI discuss? 

The American Enterprise Institute discussed their findings in the survey by expounding on the details in order to help themselves draw conclusions from the data. The primary focus of their discussion was in regards to the differences between perceptions in the US and UK surrounding e-cigarettes and their safety in comparison to regular cigarettes. As the data shows, UK smokers certainly believe that e-cigarettes are safer than smoking in larger numbers than in the US, and their attempts to quit smoking aided by alternative smoking devices were much higher as well. 

The study states, "U.S. authorities have been equivocal in the safety of new products, claiming they expose users to fewer and less dangerous byproducts compared with cigarettes, but then not definitively claiming they were any safer. However, when a health authority of a major nation, such as the UK, makes the same claim that these new products are “95% safer than cigarettes”, it is likely that many smokers will switch", which is backed up by the data they gathered. 

It's unclear that messaging from Federal governments is influential in understanding the safety of e-cigarettes and their viability to help smokers quit their habit. In the UK, where vaping is encouraged, more smokers attempt to quit with vaping and they're more successful in doing so than in the US. Is this a sign that the US government should reconsider their messaging? We can't know for certain, because there are also products in the UK that are available that are not available in the US. One example of this is the IQOS, which is a heat-not-burn product that has not yet been approved by the FDA. So, while it's clear the messaging is different, it's unclear whether it's making a statistically significant impact on the decision-making of smokers, according to the study.

What are their conclusions?

Authors of the study conclude that, "We found that a higher percentage of sampled smokers had tried them in the UK, relative to the U.S., especially among those who claimed they had tried to quit smoking previously. This difference in attitude and uptake is likely to be partly driven by public health pronouncements by UK authorities that non-combustible products are “far safer” than cigarettes. In contrast, U.S. authorities have been far more muted in their support for new non-combustible tobacco products. This might help explain why we see no significant differences in usage rates of these products among different U.S. cities (Philadelphia and DC), validating the notion that one driving mechanism is likely at the level of the federal government."

They go on to state, "While our sample is relatively small, we hope this will spur more extensive work on the role of federal policy pronouncements in influencing the take-up of vaping and other products across locations, while at the same time encouraging more evidence-based research on the advantages and costs of new products, relative to traditional smoking options, such as cigarettes."

Where does this leave us?

Well, we're not here to say, "I told you so" because most of our readers are vapers and have found the truth for themselves already. Additionally, we can't imagine Federal authorities are reading the VistaVapors blog to influence their policy decisions. However, this does leave is in a somewhat precarious position as a country, doesn't it? Here we sit, with the validity of a powerful quit-smoking tool literally at our fingertips, but much of the public does not see it as a viable option for quitting smoking. Whether public perception is influenced by government messaging or not, and we believe it is, it's important for that messaging to change for the purpose of actively improving public health. We hope that this study, and others like it, will have some kind of impact on the approach of the Federal government, but in the meantime we will continue to share our own testimony regarding the power of vaping and how it's helped us quit the smoking habit that would inevitably have a drastic effect on our long-term health.


AEI "To vape or not to vape" study: https://www.aei.org/wp-content/uploads/2019/04/Vape-WP-2019.pdf

Royal College of Physicians. “Nicotine without Smoke: Tobacco Harm Reduction” RCP Policy:

Public Health report, 2016. https://www.rcplondon.ac.uk/projects/outputs/nicotinewithout-smoke-tobacco-harm-reduction-0.

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