When I tell anyone I research e-cigarettes, they almost always have an opinion about them. A few will be vapers themselves, and those 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, especially whether they’re likely to reintroduce smoking to a young generation who have been steadily shunning it in bigger numbers over recent decades. A certain 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 recently available detailed study of more than 60,000 UK 11-16 year olds has found that young people who try out e-cigarettes are generally those that already smoke cigarettes, and also then experimentation mostly doesn’t translate to regular use. In addition to that, but smoking rates among young people in the UK are still declining. Studies conducted currently investigating the gateway hypothesis that vaping leads to smoking have tended to consider whether having ever tried an e-cigarette predicts later smoking. But younger people who try out e-cigarettes will probably be distinctive from those that don’t in a lot of different ways – maybe they’re just more keen to adopt risks, which would also raise the likelihood that they’d test out cigarettes too, whether or not they’d used e-cigarettes.
Although you can find a small minority of younger people that do begin to use best electronic cigarette without previously being a smoker, as yet there’s little evidence that this then increases the risk of them becoming cigarette smokers. Add to this reports from Public Health England which have concluded e-cigarettes are 95% safer than smoking, and you might think that might be the end of the fear surrounding them.
But e-cigarettes have really divided the public health community, with researchers that have the normal purpose of lowering the levels of smoking and smoking-related harm suddenly finding themselves on opposite sides of the debate. This is concerning, and partly because in a relative dearth of research on the devices the same findings are employed by either side to aid and criticise e-cigarettes. And all of this disagreement is playing outside in the media, meaning an unclear picture of what we realize (and don’t know) about e-cigarettes has been portrayed, with vapers feeling persecuted and people who have not yet tried to quit mistakenly believing that there’s no part of switching, as e-cigarettes might be equally as harmful as smoking.
An unexpected consequence of this could be it can make it harder to accomplish the very research needed to elucidate longer-term results of e-cigarettes. Which is one thing we’re experiencing while we attempt to recruit for your current study. We have been conducting a research project funded by CRUK, where we’re collecting saliva samples from smokers, vapers and non-smokers. We’re looking at DNA methylation, a biological marker that influences gene expression. It’s been demonstrated that smokers have a distinct methylation profile, in comparison to non-smokers, and it’s probable that these modifications in methylation may be connected to the increased probability of harm from smoking – for instance cancer risk. Whether or not the methylation changes don’t make the increased risk, they might be a marker of this. We want to compare the patterns seen in smokers and non-smokers with the ones from e-cigarette users, potentially giving us some insight into the long term impact of vaping, while not having to watch for time and energy to elapse. Methylation changes happen relatively quickly as compared to the onset of chronic illnesses.
Part of the difficulty using this is the fact we know that smokers and ex-smokers have a distinct methylation pattern, and we don’t want this clouding any pattern from vaping, which means we need to recruit vapers who’ve never (or certainly only very rarely) smoked. And this is proving challenging for just two reasons. Firstly, as borne out from the recent research, it’s very rare for individuals 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 in addition to that, an unexpected problem has been the unwillingness of some in the vaping community to aid us recruit. And they’re postpone because of fears that whatever we find, the final results will be used to paint a poor picture of vaping, and vapers, by people who have an agenda to push. I don’t desire to downplay the extreme helpfulness of plenty of people inside the vaping community in helping us to recruit – thanks a lot, you already know who you are. But I was disheartened to know that for some, the misinformation and scaremongering around vaping has reached the stage where they’re opting from the research entirely. And after talking with people directly concerning this, it’s tough to criticize their reasoning. We now have also found that a number of electronic cigarette retailers were immune to setting up posters aiming cwctdr recruit people who’d never smoked, as they didn’t wish to be seen to get promoting e-cigarette use within people who’d never smoked, which can be again completely understandable and really should be applauded.
Exactly what can we all do about this? Hopefully as more research is conducted, so we get clearer information on e-cigarettes capability to act as a quitting smoking tool, the disagreement around them will disappear. For the time being, Hopefully vapers carry on and agree to participate in research therefore we can fully explore the potential for these devices, specifically those rare “unicorns” who vape but have never smoked, as they might be essential to helping us be aware of the impact of vaping, when compared with smoking.