Peter Hajek is well known to vapers for his work focussing on harm reduction and vaping. His greatest contribution to date has been the authorship contribution to the Public Health England report, which declared vaping to be “at least 95% safer than smoking”.
Professor Hajek said at the time of its release: “My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one.”
It is this idea that lies behind the recent work at Queen Mary, because: “Up to now, very little formal evaluation exists to determine which EC characteristics appeal to smokers and drive [electronic cigarette] choice.”
Nicotine delivery is a primary concern for smokers looking to switch, but it isn’t the only focus, according to the paper. Other considerations include product appearance, ease of use, puff resistance, ‘throat hit’, vapour volume, mouthpiece comfort, handling characteristics, e-liquid flavour, other constituents, cost and product marketing.
The team recognise that smokers often start with a ‘cig-a-like’ product (“that are cheaper and easier to use”), but those who switch to vaping completely typically progress to refillable devices. Not only are more advanced systems more popular but they are also strongly associated with complete cessation of smoking according to Hitchman et al. in 2015.
Of the fifteen people taking part, eleven identified as being dual-users and four had switched away from smoking completely. Participants had to be prepared to give blood samples from an intravenous line and, at the end of each session, participants were asked to rate the product used as follows:
- ‘Did it relieve your urge to smoke?’ (not at all (1)—extremely well (10));
- ‘How quickly did any effect happen?’ (very slowly (1)—extremely fast (10));
- ‘Did you like the taste?’ (not at all (1)—extremely (10));
- ‘How much nicotine do you think it delivered?’ (too little (1)—too much (10));
- ‘Was it pleasant to use?’ (not at all (1)—extremely (10));
- ‘How hard was it to draw smoke from it?’ (too easy (1)—too hard (10));
- ‘How comfortable was the mouthpiece?’ (not at all (1)—extremely (10));
- ‘How would you rate the amount of vapour?’ (too little (1)—too much (10));
- ‘How would you rate the “hit” at the back of your throat?’ (too little (1)—too much (10));
- ‘How likely would you be to recommend it to friends?’ (not at all (1)—extremely (10)).
The team concludes: “Refillable products deliver higher nicotine levels and generate better consumer ratings in general than cig-a-likes with similar nicotine content. Lower nicotine delivery is associated with more frequent puffing.”