Among the many criticisms opponents of e-cigs raise, one of the core themes is the notion that they will perpetuate nicotine use in general, attracting ex-smokers and non-smokers as well as intensifying the nicotine addiction of “dual users” (who vape and smoke). The results of research to date has not been in support of this conclusion, and new data from the Smoking Toolkit Study investigating the latest trends in e-cigarette use in England has provided further evidence that these concerns are utterly unfounded.
The Smoking Toolkit Study
The study takes the form of monthly household surveys of around 1,800 respondents aged 16 or over, with approximately 450 smokers in each sample. The survey has been running since 2006, and as such has collected a large amount of evidence on the topic of smoking and quit attempts. They started gathering data on e-cigarettes in the second quarter of 2011, and have since charted the rise of the technology and the concurrent decrease in the use of things like nicotine replacement therapy (NRT), such as gums and patches. E-cigarettes overtook over-the-counter NRT as the most commonly used quit smoking method in England in the second quarter of 2013, according to previous data from the survey.
New Data: Non-Smokers Who Vape are a Rare Breed
One of the biggest concerns is that e-cigarettes will be attractive to non-smokers and thereby lead to an increase in the overall rates of smokers. The research so far has consistently shown that the overwhelming majority of vapers are smokers or ex-smokers, and the new data from this survey offers more evidence in support of that.
The results (based on a sample of 2,633) show that only around 0.3 percent of never-smokers (less than 1 in 300) use nicotine in the form of e-cigarettes, compared to 0.1 percent who use NRT products. For long-term former smokers, only 1.8 percent use e-cigarettes, but 2.9 percent use NRT. This clearly shows that non-smokers still don’t use e-cigarettes. Some use by never-smokers is to be expected (since all current smokers were once never-smokers), but this data shows that it’s still incredibly rare. Interestingly, the CDC survey of youth e-cig use showed a similar disinterest among non-smoking youth, with only 0.5 percent of that sample being non-smokers who’d vaped in the previous 30 days. As for the long-term ex-smokers, it seems like if you wanted to accuse anything of keeping them hooked on nicotine, it would have to be NRT.
E-Cigs Impacts on Quit Attempts and Motivation to Quit
The other issue addressed by this new data is whether e-cigarettes are just promoting nicotine addiction and thereby leading to a decrease in quit attempts or motivation to quit. The survey data shows that out of 723 vapers not using NRT, the “dual users” of both e-cigarettes and tobacco cigarettes are vaping every day. This is good news, because based on other research it’s reasonable to assume a reduction in cigarette use from dual users who vape every day.
On a measure of their motivation to quit, the average score from a sample of 12,094 smokers has increased overall since the technology was first included in the survey, albeit fairly marginally. In other words, e-cigarettes don’t undermine the motivation to quit; in fact, they seem to slightly enhance it. The percentage who’d attempted to quit in the last quarter has remained approximately constant since 2011, so there is no reduction in quit attempts associated with the increasing e-cig use.
Conclusion – Mostly Good News, A Little Bad News
In this generally positive set of findings, there is a negative finding too. The increasing prevalence of e-cigarette use seems to be stalling, as shown by a downward turn in their use among recent ex-smokers (after a continual rise since the start of 2012) and stagnation in usage rates among current smokers and use in respondents’ most recent quit attempts. E-cigs are still the most popular stop smoking aid (NRT use decreased even further in the most recent findings), but it could be that the persistent campaign of misinformation is having an effect.
Still, it’s pretty positive overall from the Smoking Toolkit Study. The findings clearly show that allegations from anti-smoking groups that e-cigs are hooking never-smokers on nicotine and undermining the efforts to help smokers quit are utterly unfounded. Hopefully, the apparent plateau in the rise of e-cigarette use is just a random fluctuation in popularity and not the start of a larger trend.
Photo credit: Deanna Trombley / Daily Titan