“Stopping smoking is one of the best things you'll ever do for your health. When you stop, you give your lungs the chance to repair, and you'll be able to breathe easier. There are lots of other benefits too - and they start almost immediately,” says the National Health Service (1).
And the NHS recognises that one of the most popular routes away from tobacco: “In recent years, e-cigarettes have become a very popular stop smoking aid in the UK. Also known as vapes or e-cigs, they're far less harmful than cigarettes and can help you quit smoking for good.” (2)
From not having much evidence supporting vaping ten years ago, the UK E-cigarette Research Forum and Cancer Research UK publish a monthly research update of over 130 vape studies every month (3). Studies now cover everything from how effective e-cigs are as a quit tool to the relative safety of vaping and the need for flavoured e-liquids.
The Health impact of smoking
The danger of smoking is beyond debate these days. Even the most ardent supporter of the right to make the choice to use tobacco will acknowledge the clear risks it presents. Private health provider BUPA states: “Smoking is the most common cause of preventable disease in the UK. Nearly 78,000 people die each year in the UK from smoking-related causes.” (4)
Tobacco smoke contains over 5,000 different chemicals, of which the majority are either carcinogenic (cause cancer) or poisonous. The British Lung Foundation says, “smoking can affect every part of the body - from your skin to your brain. Outside the lungs smoking causes heart attacks, strokes and cancer. On average, smokers live 10 years less than non-smokers.” (5)
The evidence is clear that not smoking can lead to long-term health benefits.
Is nicotine dangerous?
The Royal College of Physicians has said that the “use of nicotine alone, in the doses used by smokers, represents little if any hazard to the user” (6).
Indeed, Professor John Britton, who works for the Tobacco Advisory Group, has said that nicotine is not “a particularly hazardous drug” and has added that it ought to be considered in the same way that we think about caffeine (7). The Royal Society of Public Health thinks the same (8), it said: “nicotine by itself is fairly harmless…not too dissimilar to caffeine addiction.”
In their 2013 report titled Tobacco Harm Reduction and Nicotine Containing Products (9), Cancer Research UK stated that nicotine, beyond its mildly addictive properties outside of cigarettes, has no established short- or long-term danger.
The nicotine found in e-liquid is the same as that used in traditional patches and gum used for quitting smoking. The National Institute for Health and Care Excellence looked at the evidence and stated: “Six studies evaluated the safety of NRT in patients with cardiac disease and did not find any increased incidence of cardiovascular events or any other adverse events.” (10)
What is the health impact of vaping?
Public Health England (PHE) released a ground-breaking review in 2015(11). In it, PHE said: “The current best estimate is that e-cigarettes are around 95% less harmful than smoking.”
Worryingly, it added that a sizeable proportion of the UK population didn’t appreciate that vaping was far safer than smoking and, as discovered by ASH in a 2019 study (12), “the proportion of smokers correctly believing vaping is less harmful than smoking has fallen to just under a half.”
Is there a second-hand risk from vaping to others?
It has been well accepted that smoking tobacco produces second-hand smoke that is dangerous, “especially for children” according to the NHS. But what is the danger of vaping near other people?
The NHS says that as vaping doesn’t involve combustion and doesn’t produce smoke, so “the risks of passive smoking with conventional cigarettes don't apply to e-cigs…E-cigs release negligible amounts of nicotine into the atmosphere and the limited evidence available suggests that any risk from passive vaping to bystanders is small relative to tobacco cigarettes.”(13)
What is the effect of smoking or vaping during pregnancy?
The Royal College of Obstetricians and Gynaecologists says the impact of smoking is clear (14):
- Smoking is harmful to the mother and baby
- Passive smoking can harm the mother and baby
- Smoking will lead to an underweight baby and that is bad for its health
- The best thing to do is stop smoking, especially when pregnant
The Smoking in Pregnancy Challenge Group is a partnership between the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health. The Challenge Group has produced a range of educational materials for pregnant women and the health professionals who work with them.
The Challenge Group says that, “E-cigarettes are much less harmful to health than tobacco,” and goes on to add that, “if a pregnant woman chooses to use an e-cigarette to help her quit smoking and stay smokefree, she should be supported to do so.” (15)
It adds: “There is no reason to believe that using an e-cigarette would compromise breastfeeding. Women who vape following birth should not be discouraged from doing so if it enables them to stay quit and maintain a smokefree home.”
Expert Professor Linda Bauld has previously denounced studies that attack vaping during pregnancy, stating: “Their hypothesis that it is the nicotine in e-cigarettes that may be to blame is not supported by previous research in humans. The large SNAP trial found that young children whose mothers had used nicotine replacement therapy after stopping smoking in pregnancy had normal development up to two years old.” (16)
What are the positives and negatives of switching from smoking to vaping?
The benefits extend beyond the physical, even if these are very important. For example, researchers based in Dundee found that switching improved the cardi-vascular system and led to reduced chances of suffering from heart attacks and strokes. (17)
As vapers have discovered, two of the most immediate benefits of switching is that the sense of smell and taste return – hence the popularity of the wide range of flavoured e-liquids. Speaking at a press conference hosted by the New Nicotine Alliance (18), Dr Sharon Cox, a researcher at London South Bank University, said: “The evidence suggests flavours are one of a few key components, important to both the new vaper and the experienced vaper, which help people abstain from smoking.” (19)
Smokers are very familiar with the yellow staining on their fingers and teeth (20). “E-cigarettes do not produce tar or carbon monoxide,” according to the NHS (2), so staining doesn’t happen when a smoker swaps from cigarette use to vaping. Also, with no carbon monoxide being released the ex-smoker will quickly find their breathing improves and means they can exercise more comfortably.
Is there a cost benefit of not smoking?
It costs around £13.30 per day for a major brand pack of 20 cigarettes. This equals £93.10 per week for a 20-a-day smoker, an incredible £372.40 per month, and almost an amazing £4500 per year.
Once an ex-smoker has bought a device, the ongoing cost is limited to coils and juice. A mouth-to-lung vaper could easily limit their spending to less than £25 per month meaning they would save £4200 over a year - the cost of a reasonable second-hand car or a very decent family holiday.
- The National Health Service, “Quit Smoking” - https://www.nhs.uk/better-health/quit-smoking/
- The National Health Service, “Using e-cigarettes to stop smoking” - https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes-to-stop-smoking/
- UK E-cigarette Research Forum and Cancer Research UK, monthly research update - https://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy-on-preventing-cancer/our-policy-on-tobacco-control-and-cancer/uk-e-cigarette-research-forum#UKECRF2
- BUPA, “Effects of smoking” - https://www.bupa.co.uk/health-information/lungs-breathing/effects-of-smoking
- British Lung Foundation, “Why is smoking bad for me?” - https://www.blf.org.uk/support-for-you/smoking/why-is-smoking-bad-for-me
- Royal College of Physicians, Nicotine Without Smoke -- Tobacco Harm Reduction” - https://www.rcplondon.ac.uk/file/3563/download?token=Mu0K_ZR0
- Professor John Britton - https://www.bbc.co.uk/news/uk-21406540
- The Royal Society of Public Health,
- Cancer Research UK, Tobacco Harm Reduction and Nicotine Containing Product - https://www.cancerresearchuk.org/sites/default/files/tobacco-harm-reduction.pdf
- The National Institute for Health and Care Excellence, “Smoking: harm reduction. Public health guideline” - https://www.nice.org.uk/guidance/ph45
- Public Health England, “E-cigarettes around 95% less harmful than tobacco estimates landmark review” - https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review
- Action on Smoking and Health, "Use of e-cigarettes (vaporisers) among adults in Great Britain” - https://ash.org.uk/wp-content/uploads/2019/09/Use-of-e-cigarettes-among-adults-2019.pdf
- NHS, “Passive smoking” - https://www.nhs.uk/live-well/quit-smoking/passive-smoking-protect-your-family-and-friends/
- Royal College of Obstetricians and Gynaecologists, “Smoking and pregnancy” - https://www.rcog.org.uk/en/patients/patient-leaflets/smoking-and-pregnancy/
- The Smoking in Pregnancy Challenge Group, “Use of electronic cigarettes before, during and after pregnancy” - https://smokefreeaction.org.uk/wp-content/uploads/2019/07/2019-Challenge-Group-ecig-summary_A5_FINAL.pdf
- Science Media Centre, “Expert reaction to study looking at smoking and vaping in pregnancy and infant behaviour” - https://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-smoking-and-vaping-in-pregnancy-and-infant-behaviour/
- New Scientist, “Long-term smokers who start vaping see health benefits within a month” - https://www.newscientist.com/article/2223624-long-term-smokers-who-start-vaping-see-health-benefits-within-a-month/
- The New Nicotine Alliance - https://nnalliance.org/
- Planet of the Vapes, “NNA Flavour Warning” - https://www.planetofthevapes.co.uk/news/vaping-news/2019-06-18_gfn-nna-flavour-warning.html
- Smoking and tooth discolouration: Findings from a national cross-sectional study - https://www.researchgate.net/publication/7946282_Smoking_and_tooth_discolouration_Findings_from_a_national_cross-sectional_study