In late 2018, there is still considerable confusion amongst the general public about the potential dangers of e-cigarette (or vaping) use in the United States, Canada and the UK. This, despite the recent legalization of vaping products in Canada and the fulsome embrace of vaping by health authorities in the UK as an effective tool to quit smoking.

Public Health England: Key findings on e-cigarettes

  • ECs are much less harmful than smoking – at least 95%, with the risk of cancer calculated to be less than 1%

  • ECs are the most popular stop smoking aid in England

  • Of the 2.9 million adult e-cigarette users in the UK, more than half have completely stopped smoking

  • A further 770,000 have given up both smoking and vaping

  • Growing popularity of e-cigarettes seems to have had no negative impact on youth smoking rates which continue to decline

  • While nicotine is the addictive substance in cigarettes, it is relatively harmless

  • Nicotine is not a carcinogen

  • Although nicotine is the reason people become addicted to smoking, it is the thousands of chemicals contained in cigarette smoke that causes almost all of the harm

  • There have been no identified health risks of passive vaping to bystanders

  • 50% of UK smokers have never tried an e-cigarette because their perception of potential risks is not founded on the evidence

  • "We really want to get the message out that they really should consider using an e-cigarette because they're a lot better for them than continuing to smoke"


PHE | Health matters: stopping smoking - what works? (09.25.2018)

PHE | Clearing up some myths around e-cigarettes (02.20.2018)

PHE | Key questions and findings from our e-cigarette evidence update (02.06.2018)

BBC | E-cigarettes 'should be on prescription' (02.06.2018)

United States - Overview

The public health battle being waged over vaping in the U.S. runs contrary to the evidence reported in numerous academic papers published in accredited journals.

In addition, although begrudgingly, the U.S. Food & Drug Administration has recognized the potential of e-cigarettes to reduce the harm caused by smoking. However, FDA is under intense pressure from major U.S. public health organizations to restrict or even ban vaping:

  • Cigarette smoking is the leading cause of preventable disease and death in the U.S.

  • 480,000 Americans die every year or about 1 in 5 deaths

  • 15.5% of Americans currently smoke or 15 of every 100 adults aged 18-years or older

  • 38 million adults are current smokers in the United States

  • 9 million Americans use e-cigarettes

  • $6.6 billion U.S. vaping market, full-year sales forecast 2018

  • $3.5 billion traditional vaping segment – mods and eliquids

  • $3.1 billion automatic vape segment – pods (Juul and others)


CDC | Current Cigarette Smoking Among Adults in the United States (09.24.2018)
NCHS | Electronic Cigarette Use Among Adults: United States (10.2015)
CNBC | E-cigarette sales are booming thanks to Juul (08.21.2018)

Misperception of Vaping Risks Go Unanswered (2018)

Positive impact of e-cigarettes in the U.S. may have been slowed by exaggerated claims of their harms and the harms of nicotine in general:

  • 5.3% (only) of Americans correctly believe e-cigarettes are “much less harmful” than combustible cigarettes

  • 37% believe they are the same or worse than smoking, 34% don’t know

  • Misperceptions of the harms of nicotine and e-cigarettes have recently increased

  • A misinformed public lacks the information required to take health-protective action

  • Accurate public education is needed to counteract misperceptions of harm from nicotine and e-cigarettes

  • E-cigarettes should always be compared with smoked tobacco products (relative harms)

  • Mistaken public beliefs that nicotine is the cause of disease risk and cancer, rather than the smoke from combustion, must be dispelled

  • Fears that nicotine causes cancer discourages use of FDA-approved NRTs as well as e-cigarettes and other ANDS as viable ways to stop smoking cigarettes


Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives (06.01.2018)

David B. Abrams, Allison M. Glasser, Jennifer L. Pearson, Andrea C. Villanti, Lauren K. Collins, and Raymond S. Niaura

College of Global Public Health, New York University
Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC
School of Community Health Sciences, University of Nevada
Vermont Center on Behavior and Health, University of Vermont

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