ASH UK: E-cigarettes will save the lives of children

ASH (Action on Smoking and Health) UK released some very interesting statistics on the 25th of April: http://www.ash.org.uk/files/documents/ASH_891.pdf. Their statistic material is based on a series of studies starting back in 2010 and repeated in February 2012, March 2013 and March 2014. In March 2013 an additional survey of children aged 11 to 18 was conducted.

ASH estimates there are 2.1 million adult e-cigarette users in Great Britain in march 2014. 700.000 of these are ex-smokers while 1.3 million continues to use tobacco. The study also concludes that 35% of British adults believe that electronic cigarettes are good for public health, while 22% disagrees with this. That leaves a pretty big number of people that still haven't got an opinion on this. I've written earlier about how vapers and their behaviour can affect what attitude these people will end up with towards vaping: http://vapingiraffe.blogspot.no/2014/04/responsible-vapers-can-give-us.html

Among adult smokers in the UK the number that has ever tried e-cigarettes has gone from 8.2% in 2010 to 51.7% in 2014. Regular use among smokers (dual-users) has gone from 2.7% to 17.7% in the same period of time. Among ex-smokers the number that has ever tried has gone from 3.7% to 11.8% and regular use has gone from 1.1% to 4.7%. This was a bit surprising to me, as this can suggest that over half of the people that quit smoking by e-cigarettes, also quits the e-cigarette use after a while. The study however gives no such conclusion as it has no data to support this since the "ever tried" term covers everything from people who has tried it once to people who has used them for months or even years and then stopped. The most interesting numbers, however, are these: Among never smokers 1.1% say they have ever tried an e-cigarette, but only 0.1% (virtually none) continues the use. There goes your gateway argument out the window.
 
Among ex-smokers the most common reasons given for use is a quit attempt (71%) or "to help me keep off tobacco" (48%). Among smokers "help me reduce the amount of tobacco I smoke, but not stop completely" (48%) and "to save money compared with smoking tobacco" (37%) are the most common reasons. The study also examined the variation in products used showing that re-chargeable e-cigarette kits with replaceable pre-filled cartridges (cig-alikes) are the most common type that people try first and also the most common one for continued use. However, ex-smokers (people who managed to quit completely) prefers more advanced e-cigarettes with refillable tanks. This could mean that these are more effective in helping people quit, but again, the study has insufficient data to conclude something like that. For more details on the various types of e-cigarettes used, see the study.

The most interesting part of this study, in my opinion, is the part where use among children is examined. I urge you all to read it. The conclusions made from this part are these:

• Understanding of electronic cigarettes among children is generally good.
• Among children who have heard of electronic cigarettes, sustained use is rare and confined to children who currently or have previously smoked.
• Few children expect to use an electronic cigarette soon, except those who already smoke.
• Frequent (more than weekly) use of electronic cigarettes by children was confined almost entirely to ex-smokers and daily smokers.

This means that e-cigarette use patterns among children looks very much like the ones for adults: They are almost exclusively used by children who already smoke. Among children that has never smoked, only 1% have tried an e-cigarette once or twice, and the study concludes there is no evidence of regular electronic cigarette use among children who have never smoked or who have only tried smoking once. In other words, electronic cigarettes have the potential to save children from a life-time of tobacco use, as the numbers also very strongly indicates that the gateway argument is totally invalid. The numbers provided by ASH in this studies shows that the rising number of children and young people who experiments with e-cigarettes should be viewed as encouraging rather than worrying.

Vapers create vapers, smokers create smokers: Think of the children!

Would you rather see your kids smoking?
Photo credit: James Alby via photopin cc

Another one of the anti-e-cigarette movements favourite arguments at the moment is that we need to think of the children. They seem to be loosing a lot of sleep worrying about kids taking up vaping, believing this is a safer alternative to smoking. So let's do that for a moment shall we, think of the children I mean. First lets start with looking on the main reasons young people start smoking:

• Their parents are smoking
• Peer-pressure 
• Stress relief
• Rebellion and showing independence
• Mimicking the behaviour of people around them
• Smoking to look cool
• Smoking to look older
• Experimenting and adventure

How will the availability of e-cigarettes and vaping affect this? Well actually they can all be applied to vaping as well. So if parents are vaping, there is a chance their kids will, peer-pressure from other young vapers will exist, they might use vaping as stress relief, to rebel against parents and so on. So we will have young people that start vaping without smoking first. But think about this... if a teenager starts vaping because his or her parents are vaping, wouldn't the same teenager have started smoking if the parents were smoking? If stress relief was the main reason for starting to vape, wouldn't the alternative be smoking? If your kids wants to experiment, would you rather have them experiment with vaping or smoking? The point is that these reasons will not go away if you remove vaping, but vaping will be an alternative for young people that would otherwise start smoking. By demonizing vaping, young people would start smoking instead. Cause their parents would be smokers instead of vapers, their friends would experiment with smoking instead of vaping, they would use smoking to fit in socially instead of vaping or they would light up a cigarette to look cool instead of pulling out their e-cig.

The important point here, that seems to be missed by most anti e-cigarette advocates, is that e-cigarettes and vaping replaces smoking. Not only for smokers but also for young people that would otherwise have started smoking. If a teenager is mimicking other vapers around them, it is because there are less  smokers around them to mimic. So yes, we will have young people that starts vaping without smoking first, but most of these people would have gone straight to smoking instead if vaping wasn't an alternative. I say most people, because there might be people that wouldn't have started smoking, but starts vaping because of the reasons above combined with their belief that vaping is safe. But this won't kill them! However restricting e-cigarette use and advertising will kill a lot of people. So what is most important? Making sure that no-one picks up a relatively harmless habit of vaping unnecessarily or making sure that as few as possible picks up the deadly habit of smoking?

Not only does vaping replace smoking but in most cases it gives the user something more in addition. And that is what makes them more effective than any other smoking cessation product (read my post on this here: http://goo.gl/Sf0Cn6), but also what makes the gateway argument invalid. The reason people struggle to go from smoking to nicotine gum, is the same reason that people would "struggle" to go from vaping to smoking. It would take something away.

To all the e-cigarette sceptics out there: Vaping adults will lead to kids vaping, smoking adults will lead to kids smoking. What would you rather have your kid doing, vaping or smoking? Think of the children!