April 15, 2015

expert reaction to surveys of e-cigarette use in teenagers

Researchers publishing in the BMJ Open have surveyed a group of school-age children in Wales to examine habits around use of cigarettes and e-cigarettes. The study reports that regular smokers were more likely than non-smokers to use e-cigarettes, and that around 1.5% of those sampled regularly used e-cigarettes.

Prof. Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said

“The results of this large survey tally with all other available data and the picture is consistently reassuring. E-cigarettes do not attract non-smokers.

“Just in case the readers heard somewhere that e-cigarettes are a gateway to smoking and are now confused, it may be useful to know that some publications on e-cigarettes are employing a politically motivated sleight of hand which keeps raising false alarms. It would seem logical that the phrase ‘regular e-cigarette use’ means the same thing as ‘regular smoking’, i.e. daily use over an extended period of time. Tendentious ‘studies’ however use the phrase for adolescents who tried an e-cigarette twice over the past two months. Inconsequential experimentation is presented as hard-core use. Studies which actually looked for non-smokers who are vaping daily found none.”

Prof. Linda Bauld, Professor of Health Policy, University of Stirling, said:

“This new article provides evidence from Wales that is consistent with what we see in a growing number of similar surveys from a large number of countries. Teenagers are experimenting with e-cigarettes and these devices can be appealing to young people. However, as is consistent with studies elsewhere, a tiny proportion – here less than a third of one percent – of non-smoking young people goes on to regularly use an e-cigarette.

“The survey that reported this result was large, involving over 9,000 11-16 year olds, and is part of a well-established international study, which can give us greater confidence in the results.

“Age of sale laws for e-cigarettes will be introduced soon in both England and Wales and it will be important that these are enforced, particularly for nicotine-containing e-cigarettes. However, it may be time to move on from the moral panic that e-cigarette experimentation in young people elicits amongst some. This study strikes a helpful balance in making clear that it contains no evidence that e-cigarettes are currently acting as a gateway to tobacco smoking for young people in Wales.”

Prof. Paul Aveyard, Professor of Behavioural Medicine, University of Oxford, said:

“This study shows that teenagers do what teenagers do: they experiment with smoking and nowadays also with e-cigarettes. Consequently some people who have never tried tobacco cigarettes try e-cigarettes but only a few use them at least monthly, suggesting they are unattractive to people who do not smoke. About a fifth of regular smokers are using e-cigarettes, which is not a concern because e-cigarettes are less likely to harm users than are tobacco cigarettes. It does not show us anything about whether e-cigarettes help teenagers quit. It is hard to measure rare events but this survey was large enough to be sure that fewer than 1 in 200 never-smokers used an e-cigarette at least once a month.”

Prof. David Nutt, The Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Imperial College London, said:

“This is an important and relatively large-scale survey on a very topical and important and under-researched topic. It shows what we might predict – that smokers of cigarettes and cannabis also use e-cigarettes. For the rest of people, use of e-cigarettes is limited.

“My personal view is that e-cigarettes are unlikely to be remotely as harmful as cigarettes (see our recent analysis http://www.karger.com/Article/FullText/360220). Even if everyone used e-cigarettes the burden of harm would be less than that of current cigarette smoking.”

‘Electronic-cigarette use among young people in Wales: evidence from two cross-sectional surveys’ by Graham Moore et al. published in BMJ Open on Wednesday 15 April 2015. 

All our previous output on this subject can be seen at this weblink:

http://www.sciencemediacentre.org/tag/e-cigarettes/

Declared interests

Prof. Peter Hajek: “I have no links with any tobacco or e-cigarette manufacturers. My research into the safety and effects of e-cigarettes is funded by UKCTAS, MHRA and NIHR.”

Prof. Linda Bauld chaired the programme development group on tobacco harm reduction that was responsible for producing guidance on harm reduction for the National Institute for Health and Care Excellence (NICE) in 2013.

Prof. Paul Aveyard: “I am paid by the University of Oxford and as a doctor in the NHS.  My grant funding comes from NIHR and various medical charities and I work on smoking cessation.  I am a member of various royal colleges and the UK Society for Behavioural Medicine and sit on the NICE Public Health Advisory Committee.  I have done work for the pharmaceutical industry on smoking cessation: in the last three years I have done one day of consultancy for Pfizer on general smoking cessation.”