Massive study definitively answers whether smoking or vaping is worse for your health
Among smokers in England: over half of them hold mistaken beliefs about the relative harm of vaping compared to smoking. (CREDIT: Creative Commons)
A recent study led by researchers from University College London (UCL) reveals a concerning trend among smokers in England: over half of them hold mistaken beliefs about the relative harm of vaping compared to smoking.
The study, published in JAMA Network Open and supported by Cancer Research UK, analyzed survey responses from 28,393 smokers in England spanning from 2014 to 2023. Results indicate a significant decline in the perception of e-cigarettes' safety over the past decade, coinciding with a surge in vaping among youth.
Lead author Dr. Sarah Jackson from the UCL Institute of Epidemiology & Health Care highlighted the implications of these findings for public health. "The risks of vaping are much lower than those of smoking, but this fact isn't being effectively communicated," she stated.
"This misperception poses health risks as it may deter smokers from switching to e-cigarettes, which could substantially reduce harm. Additionally, it may prompt young e-cigarette users to take up smoking if they perceive the risks as comparable."
Dr. Jackson stressed the necessity of better communication regarding the health risks associated with vaping, empowering smokers to make informed choices about nicotine products.
The research utilized data from the Smoking Toolkit Study, which interviews approximately 1,700 representative adults in England monthly.
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In 2014, perceptions of e-cigarettes were more positive, with 44% of smokers viewing them as less harmful than traditional cigarettes, and only 11% considering them more harmful. However, by 2023, this perception had shifted, with 23% believing e-cigarettes to be more harmful.
The study identifies a sharp decline in perceptions of e-cigarette safety in late 2019 and early 2020, coinciding with the EVALI outbreak in the United States.
This outbreak, initially attributed to nicotine e-cigarettes but later linked to illicit cannabis vaping products containing vitamin E acetate, contributed to widespread misconceptions about the safety of e-cigarettes.
Harm Perceptions of E-Cigarettes vs Cigarettes Among 28 393 Adults Who Smoke in England, November 2014 to June 2023. (CREDIT: JAMA Network Open)
Despite a partial recovery in perceptions by late 2020, concerns about youth vaping led to further declines in perception from 2021 to 2023, particularly among individuals under 35. Notably, although vaping is more prevalent in this age group, their belief that e-cigarettes are more harmful than cigarettes increased.
Senior author Professor Jamie Brown from the UCL Institute of Epidemiology & Health Care emphasized the role of media coverage in shaping perceptions of e-cigarettes. "E-cigarettes have garnered substantial media attention, often exaggerating their health risks compared to smoking," he stated. "Conversely, there is minimal reporting on smoking-related deaths, despite the staggering toll it takes annually."
Harm Perceptions of E-Cigarettes vs Cigarettes Among 28 393 Adults Who Smoke in England, November 2014 to June 2023. Modeled monthly time trends: lines represent modeled weighted prevalence by monthly survey wave (modeled nonlinearly using restricted cubic splines, 5 knots), shaded bands represent SEs, and points represent observed weighted prevalence by quarter.(CREDIT: JAMA Network Open)
Professor Brown underscored the potential impact of misconceptions on public health initiatives, such as the government's plan to provide one million smokers with free vaping starter kits and behavioral support to aid cessation. "This initiative could be hindered if many smokers are reluctant to try e-cigarettes due to unfounded beliefs about their harm," he warned.
Stark differences between smoking and vaping
The NHS provides online guidance highlighting the stark differences between smoking and vaping. Cigarettes emit thousands of harmful chemicals when burned, many of which are carcinogenic and contribute to serious illnesses such as lung disease, heart disease, and stroke.
Trends in the Perception of E-Cigarettes as Less Harmful Than Cigarettes Among Adults Who Smoke in England. (CREDIT: JAMA Network Open)
Vape aerosol, in contrast, lacks most of the harmful chemicals found in tobacco smoke, including tar and carbon monoxide.
The study underscores the urgent need for accurate communication about the relative risks of vaping and smoking. Addressing misconceptions is essential to empower smokers to make informed choices that can positively impact public health.
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