Great Britain and the United States haven't always seen eye-to-eye. The latest example: e-cigarettes. Politicians and public health authorities in the U.S. continue to view e-cigs with caution while England has taken a more positive view -- most notably a new report from Public Health England (PHE) that finds e-cigs about 95% less harmful than smoking.
"My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health," said Professor Peter Hajek of Queen Mary University. Hajek co-authored the report with Professor Ann McNeill of King's College London.
The expert independent evidence review also finds "no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers." That contradicts a study by the University of California last year that found that adolescents who used the devices were more likely to smoke cigarettes and less likely to quit smoking.
Falling smoking rates
The review, commissioned by Public Health England (PHE) -- an arm of the British Department of Health -- goes further and suggests that e-cigarettes may be contributing to falling smoking rates among adults and young people.
The review found that almost all of the 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers, most of whom are using the devices to help them quit smoking or to prevent them going back to cigarettes.
It also provides reassurance that very few adults and young people who have never smoked are becoming regular e-cigarette users (less than 1% in each group).
Emerging evidence suggests some of the highest successful quit rates are now seen among smokers who use an e-cigarette and also receive additional support from their local stop smoking services.
Time to reconsider?
The report drew the expected response from the American Vaping Association, which represents manufacturers of the electronic nicotine delivery devices. It called for U.S. organizations and government agencies like the American Cancer Society, American Lung Association, Campaign for Tobacco-Free Kids, and Centers for Disease Control & Prevention (CDC) to reassess their views on vaping.
Nothing better illustrates the attitude gap between the U.S. and Britain than the concern expressed by U.K. health officials that too many people think e-cigs are just as harmful as traditional cigarettes.
"The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting. Local stop smoking services should look to support e-cigarette users in their journey to quitting completely," said Professor Kevin Fenton, Director of Health and Wellbeing at Public Health England. "E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm."
Ann McNeill, co-author of the review, agreed:
There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely.
E-cigarettes could be a game changer in public health in particular by reducing the enormous health inequalities caused by smoking.