Research & Commentary: Qualitative Study on E-cigarettes Shows More Evidence of Tobacco Harm Reduction

Published July 19, 2016

A new study published in The International Journal of Environmental Research and Public Health in June 2016 provides additional evidence showing e-cigarettes and vaporized nicotine products (VNPs) are an effective tobacco harm-reduction tool. The study is the first qualitative analysis on e-cigarette users and VNPs “using individual interviews of adult current and former vapers” in an effort to understand the reasoning behind “initiation” of such products.

Utilizing a sample size of “13 males and 17 females,” the study sought to uncover the reasons why smokers initiate the use of e-cigarettes and VNPs; “to relate the findings to an established theory of behavior change”; and the study considered “the implications of the findings for policy research.”

The study found many factors encouraged individuals to try e-cigarettes and VNPs, including “the concept of harm reduction, easy access to cheap cigalikes in shops … encouragement from social network members, ability to vape in public places, and belief in their effectiveness.”

The study is just the latest example of growing research displaying the effectiveness of e-cigarettes and VNPs as tobacco harm-reduction strategies. In 2015, Public Health England encouraged policymakers to promote the use of these products as smoking-cessation devices, pointing to the fact the chemicals found in e-cigarettes and VNPs are “95 percent less harmful than cigarettes.”

In 2016, the Tobacco Advisory Group of the Royal College of Physicians repeated Public Health England’s call, reiterating health problems “arising from long term [vapor] inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.” The group also suggested the importance of promoting e-cigarettes and VNPs for the interest of public health.

According to the Centers for Disease Control and Prevention, tobacco cigarettes are accountable for “more than 480,000 deaths per year in the United States,” and an estimated 16 million Americans are living with smoking-related diseases. Tobacco cigarettes carry a total economic cost of over $300 billion a year, making it one of the most expensive, preventable costs associated with health care in the United States. One study estimated Medicaid savings due to e-cigarette “adoption, and the resulting tobacco smoking cessation and harm reduction” totaled $40 billion in 2012.

Despite this study and other similar studies showing the benefits of e-cigarettes, the Food and Drug Administration recently ordered e-cigarettes and VNPs to be classified and regulated as though they are tobacco products. The new ruling, which takes effect in August, requires any e-cigarette or VNP product that was introduced to the market after 2007 to apply for a “premarket tobacco application.”

Policymakers should continue to analyze the growing body of literature on e-cigarettes and VNPs before overregulating the market. Overregulation of the industry could bring more harm to health than good. States should take sound science into consideration when deliberating the creation of regulations or taxes on e-cigarette products. States imposing bans, excessive regulations, or high taxes on e-cigarettes could be creating an environment in which consumers choose to use more-harmful traditional cigarettes, rather than less-harmful alternatives.

The following documents provide additional information on e-cigarettes and tobacco harm reduction.

How and Why Do Smokers Start Using E-Cigarettes? A Qualitative Study of Vapers in London, UK
In one of the first qualitative analyses on e-cigarettes ever conducted, researchers at the King’s College London published a study The International Journal of Environmental Research and Public Health in June 2016 that aims to describe how and why smokers start to vape and what products they use; relate those findings to the COM-B theory of behavior change; and to consider implications for e-cigarette policy research.

Research & Commentary: Study Reports Health Benefits from E-cigarette Use
In June 2016, the British Medical Journal published a study that examined electronic cigarette use after 24 months. Finding a 40 percent disparity between smokers who used e-cigarettes to quit smoking and smokers who did not use e-cigarettes, the authors found, “[E]-cigarette use alone might support tobacco quitters remaining abstinent from smoking.” In this Research & Commentary, Government Relations Coordinator Lindsey Stroud argues the growing body of evidence suggests the Food and Drug Administration may have been too hasty in its May 2016 decision to regulate e-cigarettes as tobacco products.

Research & Commentary: Electronic Cigarettes 
Heartland Institute Senior Policy Analyst Matthew Glans examines electronic cigarettes, tobacco harm reduction, and various proposals to regulate e-cigarette use. E-cigarettes have become one of the most popular nicotine replacement products and a key building block in tobacco harm reduction strategies.

Nicotine without smoke: Tobacco harm reduction
This report aims to provide a fresh update on the use of harm reduction in tobacco smoking, in relation to all non-tobacco nicotine products but particularly e-cigarettes. It concludes that, for all the potential risks involved, harm reduction has huge potential to prevent death and disability from tobacco use, and to hasten our progress to a tobacco-free society. 

Research & Commentary: New CDC Report Finds Vaping Helps Smokers Quit 
A new report released by the Centers for Disease Control and Prevention (CDC) found only 0.4 percent of the people who had never smoked tobacco in a CDC study group are current vapers, which the report defines as using a vaping device either every day or some days. The CDC report, the first of its kind, estimates e-cigarette use among U.S. adults using a nationally representative household survey. The report’s findings claim only 3.4 of adults who have never smoked have tried an e-cigarette; 12.6 percent of Americans have tried an e-cigarette; and fewer than 4 percent of the U.S. population are regular e-cigarette users.

Electronic Cigarette Use Among Adults: United States, 2014
This report from the Centers for Disease Control and Prevention provides the first estimates of e-cigarette use among U.S. adults from a nationally representative household interview survey, which is organized by selected demographic and cigarette smoking characteristics.  

E-Cigarettes Are Making Tobacco Obsolete. So Why Ban Them?
Matt Ridley reports vaping works better than any other method of giving up smoking, examining several studies reaching that conclusion. With the success of vaping products, he asks, why are cities banning them?


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