Medium-term evidence shows vaping is far less harmful than smoking


Latest scientific report affirmed earlier findings that vaping poses significantly lower risks compared to smoking.

Dr. Debbie Robson of Queens College London told participants of The E-Cigarette Summit on December 9, 2022 that independent reviews of scientific evidence since 2015 show that vaping, while not risk-free, exposes people to much lower levels of toxicants, compared to the risks of smoking.

Dr. Robson, a mental health nurse, a co-author of the annual evidence reviews on e-cigarettes and a trustee of Action on Smoking and Health (ASH), said this was confirmed by the latest independent review commissioned by the Office for Health & Disparities, formerly known as Public Health England, the highest health authority in the UK.

The latest report covered 413 studies since 2018 and used the list of toxicants identified by the World Health Organization, such as carbon monoxide, tobacco-specific nitrosamines (TSNAs) and volatile organic compounds (VOCs). Results of the meta-analysis show that vaping exposes people to much lower level of toxicants, compared to the levels of risk in smoking, she said.

It was the third time in seven years that the review looked into harm caused by smoking and vaping, following the 2015 and 2018 reports. The latest review included international contributions as well as studies on heated tobacco products.

“In terms of health risks, we said that vaping imposes a small fraction of the risk of smoking in the short to medium term. Consistently, vaping exposes people to much lower level, significant lower levels of risk than smoking,” she said.

The latest review looked at biomarkers of exposure to measure how much of a substance or toxicant is present in the body. It found that biomarkers are far lower for vaping than for smoking.

The review aimed to inform government and policy makers about prevalence and characteristics of vaping among adults and young people in England. It included systematic reviews on the health risks of vaping compared with smoking, and vaping compared with non-use, as well as harm perceptions about vaping and smoking.

It recommended that in terms of policy, the enforcement of age restriction instead of regulations on vaping and smoking be improved to reduce access for both products. Dr. Robson also said the increased use of disposables should be monitored and researched with improved regulatory oversight. “Where appropriate, proportionate action should be taken to reduce the appeal to young people,” she said.

Dr. Robson said, however, that the impact of vaping depends on so many things. “It depends on who is vaping, the person’s previous and current smoking history, medical history and all the comorbidity conditions they’ve got and the reasons that they’re vaping. You also have to take into account where people live and all the background exposure,” she said.

Dr. Robson said the results of the latest review are important for the people who smoke and who vape as well as those who think about taking up vaping. She said, however, that it is still better to not vape or smoke.

“How any information is communicated and more importantly how that’s perceived by the user is really important, for the millions of people who smoke, who will die in or living with chronic health conditions while we debate this,” she said.

The 10th anniversary edition of The E-Cigarette Summit was held at the Royal College of Physicians (RCP) in London, which also marked 60 years since the RCP first published its ground breaking report “Smoking and Health”, which laid the foundations for tobacco control.

Participants in the summit concluded that despite decades of tobacco control efforts and public health education on the harms of smoking, the decline in smoking rates has been frustratingly slow and smoking remains the single biggest cause of preventable death.

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