British Public Health Officials, Unlike Ours, Tell the Truth About E-Cigarettes

A new government report endorses vaping as a harm-reducing alternative to smoking.


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This week Public Health England, an agency of the British Department of Health, published a 111-page report that unequivocally describes e-cigarettes as much less hazardous than the conventional kind and recommends them as a quitting aid for smokers. "Best estimates show e-cigarettes are 95% less harmful to your health than normal cigarettes," says PHE Chief Executive Duncan Selbie in the foreword, "and when supported by a smoking cessation service, help most smokers to quit tobacco altogether." This is not the sort of thing we are used to hearing from public health officials in the United States, who tend to view e-cigarettes as a threat rather than an opportunity to reduce the death and disease associated with smoking.

The report, prepared by Peter Hajek, a professor of clinical psychology at the Wolfson Institute for Preventive Medicine, and Ann McNeill, a professor of psychiatry, psychology, and neuroscience at King's College London, finds little reason to believe that e-cigarettes are "reglamorizing smoking" or luring nonsmokers into nicotine addiction—the two main fears voiced by anti-smoking activists and public health officials who view vaping with alarm. "The comprehensive review of the evidence finds that almost all of the 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers, most of whom are using the devices to help them quit smoking or to prevent them going back to cigarettes," PHE says. "It also provides reassurance that very few adults and young people who have never smoked are becoming regular e-cigarette users (less than 1% in each group)." As in the United States, smoking rates in the U.K. have fallen as vaping rates have risen. In short, "there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers."

PHE regrets that "nearly half the population (44.8%) don't realise e-cigarettes are much less harmful than smoking." Public perceptions in the United States are even more divorced from reality. According to a Reuters poll completed on June 4, just 35 percent of Americans understand that "e-smoking is healthier than traditional cigarettes." The rest, nearly two-thirds, either disagree with that statement or don't know.

If you are wondering about the source of this misperception, look no farther than the mealymouthed and sometimes outright false statements of public health agencies and anti-smoking organizations, whose misleading pronouncements about vaping are uncritically amplified by their flacks in the press. "The long-term impact of e-cigarette use on public health overall remains uncertain," says the CDC, which calls e-cigarettes "tobacco products" even though they contain no tobacco. "When it comes to tobacco products," says CDC Director Tom Frieden, "we really have to assume they're dangerous until they're proven safe, rather than the other way around." Ron Chapman, director of the California Department of Public Health, calls e-cigarettes "a community health threat" and falsely claims "there is no scientific evidence that e-cigarettes help smokers successfully quit traditional cigarettes."

The advice from private organizations that are ostensibly interested in reducing smoking-related harm is generally not any more helpful or accurate. The American Cancer Society asks whether e-cigarettes are "safe," when the relevant question is whether they are less hazardous than conventional cigarettes, which they indisputably are. "Because the American Cancer Society doesn't yet know whether e-cigarettes are safe and effective," it says, "we cannot recommend them to help people quit smoking." The American Lung Association (ALA) says it's "a myth" that "e-cigarettes are safe" but does not address the relative hazards of smoking and vaping. The ALA also claims it's a "myth" that  "e-cigarettes can help smokers quit," which is demonstrably false, as the PHE report shows. The group suggests that the continuing declines in smoking among teenagers are "offset by the dramatic increase in use of e-cigarettes," which is scientifically absurd given the clear health advantages of vaping. 

The consequences of such misinformation can be serious. "E-cigarettes are not completely risk free," says Kevin Fenton, PHE's director of health and wellbeing, "but when compared to smoking, evidence shows they carry just a fraction of the harm. The problem is people increasingly think they are at least as harmful, and this may be keeping millions of smokers from quitting." McNeill, co-author of the PHE report, adds: "The evidence consistently finds that e-cigarettes are another tool for stopping smoking, and in my view smokers should try vaping and vapers should stop smoking entirely. E-cigarettes could be a game changer in public health, in particular by reducing the enormous health inequalities caused by smoking."