Whenever I tell anyone I research e-cigarettes, they almost always have an opinion about them. A few will be vapers themselves, and people who are almost without fail sing the praises of the device that finally helped them give up smoking. But often people who’ve never tried e-cigarettes will focus on the potential risks from using them, particularly whether they’re likely to reintroduce smoking to a young generation who have been steadily shunning it in larger and larger numbers over recent decades. A specific fear is that young adults will test out e-cigarettes and that this will be a gateway in to smoking, as well as fears around the harms from e-cigarettes themselves.
A recent detailed study well over 60,000 UK 11-16 year olds has found that younger people who test out e-cigarettes are generally those that already smoke cigarettes, and even then experimentation mostly doesn’t translate to regular use. In addition to that, but smoking rates among younger people in the UK continue to be declining. Studies conducted to date investigating the gateway hypothesis that vaping leads to smoking have tended to look at whether having ever tried an e-cigarette predicts later smoking. But young adults who experiment with e-cigarettes will probably be distinctive from those that don’t in a lot of other ways – maybe they’re just more keen to adopt risks, which would also boost the likelihood that they’d test out cigarettes too, whether or not they’d used e-cigarettes.
Although there are a small minority of young adults that do begin to use top rated electronic cigarettes without previously becoming a smoker, as yet there’s little evidence that the then increases the risk of them becoming cigarette smokers. Enhance this reports from Public Health England which have concluded e-cigarettes are 95% safer than smoking, and you will think that might be the end in the fear surrounding them.
But e-cigarettes have really divided the public health community, with researchers who may have the common aim of reducing the degrees of smoking and smoking-related harm suddenly finding themselves on opposite sides in the debate. This is concerning, and partly because in a relative dearth of research on the devices exactly the same findings are used by either side to support and criticise e-cigarettes. And all of this disagreement is playing outside in the media, meaning an unclear picture of the items we know (and don’t know) about e-cigarettes is being portrayed, with vapers feeling persecuted and people who have not yet made an effort to quit mistakenly believing that there’s no part of switching, as e-cigarettes may be just as harmful as smoking.
An unexpected results of this might be that it causes it to be harder to accomplish the very research necessary to elucidate longer-term results of e-cigarettes. And this is one thing we’re experiencing while we try to recruit for the current study. We are conducting a research project funded by CRUK, where we’re collecting saliva samples from smokers, vapers and non-smokers. We’re checking out DNA methylation, a biological marker that influences gene expression. It’s been demonstrated that smokers use a distinct methylation profile, when compared with non-smokers, and it’s probable that these modifications in methylation might be connected to the increased chance of harm from smoking – as an example cancer risk. Whether or not the methylation changes don’t result in the increased risk, they may be a marker of this. We wish to compare the patterns noticed in smokers and non-smokers with the ones from electronic cigarette users, potentially giving us some insight in the long-term impact of vaping, without having to watch for time and energy to elapse. Methylation changes happen relatively quickly when compared to the beginning of chronic illnesses.
Area of the difficulty with this particular is the fact that we know that smokers and ex-smokers have a distinct methylation pattern, and that we don’t want this clouding any pattern from vaping, which means we must recruit vapers who’ve never (or certainly only hardly ever) smoked. And also this is proving challenging for just two reasons. Firstly, as borne out by the recent research, it’s unusual for people who’ve never smoked cigarettes to consider up regular vaping. Yes, maybe they’ll experiment, but that doesn’t necessarily result in an e-cigarette habit.
But on top of that, an unexpected problem has become the unwillingness of some inside the vaping community to help us recruit. And they’re delay due to fears that whatever we discover, the outcomes will be employed to paint a poor picture of vaping, and vapers, by people with an agenda to push. I don’t wish to downplay the extreme helpfulness of plenty of people in the vaping community in helping us to recruit – thank you, you already know who you are. But I really was disheartened to hear that for some, the misinformation and scaremongering around vaping has reached the point where they’re opting out of the research entirely. And after talking with people directly relating to this, it’s tough to criticize their reasoning. We have also discovered that a number of e-cigarette retailers were resistant against putting up posters aiming cwctdr recruit people who’d never smoked, as they didn’t wish to be seen to get promoting electronic cigarette use in people who’d never smoked, which is again completely understandable and should be applauded.
So what can we all do relating to this? Hopefully as increasing numbers of scientific studies are conducted, and that we get clearer information on e-cigarettes ability to work as a quitting smoking tool, the disagreement around them will disappear. For the time being, I hope that vapers still agree to participate in research so that we can fully explore the potential of these units, in particular those rare “unicorns” who vape but have never smoked, as they may be important to helping us understand the impact of vaping, as compared to smoking.