The study by Biener and Hargreaves is called “A Longitudinal Study of Electronic Cigarette Use in a Population-based Sample of Adult Smokers: Association with Smoking Cessation and Motivation to Quit” and available to read here.
Last week he opened his column by saying: “one of the most central tenets of medicine and public health is to do no harm." He argues that, given such stark results as demonstrated by the Biener/Hargreaves study, public health officials and all those campaigning against vaping are doing smokers a huge injustice.
He said that those banning vaping in public areas are “violating this principle, causing tragic consequences by promoting smoking to a significant proportion of the population.”
In a week where my inbox has been full of stories of vaping being banned from the public areas in New York to a Montreal university campus and across the London transport network it is hard to disagree with him. It is hard not to be saddened by their collective ignorance.
The study was conducted in a scientific manner across a 2-yr longitudinal period. It is ‘proper’ science that sought to discover truths.
Siegel highlights another hugely important fact uncovered in the findings. The other aspect of vaping in the sights of the campaigners is flavourings. They would seek to remove them, as adults do not like sweet flavours.
“However, the survey included a very useful question for all smokers who had tried, intermittently used, or intensively used electronic cigarettes but discontinued e-cigarette use for some reason and returned to smoking. Specifically, these smokers were asked to name the most important reasons why they returned to cigarette smoking.
The number one reason given by smokers for stopping electronic cigarette use was the taste of the product. More than one-third (35.0%) of triers reported that taste was a major factor in their discontinuation of vaping.”
As Siegel concludes, flavours are a highly sought after aspect of vaping – and what draws quitters onto higher use/more advanced equipment, further increasing the likelihood that the quit attempt will be successful.
He continues: “It means that if electronic cigarette flavours are banned, the percentage of smokers who progress to regular e-cigarette use will plummet. Moreover, the benefits of e-cigarettes in terms of promoting smoking cessation will be largely negated. Worst of all, thousands of smokers who would otherwise have been likely to reduce their cigarette consumption or perhaps quit with e-cigarettes will instead return to cigarette smoking or never give e-cigarettes the light of day.”
The public health disaster would be accompanied by increased revenue for Big Tobacco and Big Pharma – regulation will result in the lost opportunity to save lives.
As is so often overlooked when reporting youth vaping figures, Siegel goes on to point out: “In fact, the current evidence base does not suggest that the use of flavoured e-cigarettes is causing any net harm. If anything, it appears that youth e-cigarette use might be associated with some amount of smoking reduction among youth smokers.”
Legislators need to think about the sums, they need to consider the cost benefit of a healthier population and contrast it with what they currently have to pay for the treatment of smoking related diseases. But then “Six times more likely to quit” ought to be the only sum worth considering.