Alongside the continuous deluge of misinformation about vaping, there is a continuous stream of data revealing the reality of the situation. People like Stanton Glantz will make extreme statements based on bad studies (probably conducted by him) and be given platforms around the world to spread his message, while hard-working researchers like Dr. Konstatinos Farsalinos struggle to even get recognition in the media for his many well-conducted pieces of research.
This is true in just about every aspect of the vaping debate, but one particularly insidious example is the “debate” around whether vaping really helps smokers quit. It does. But that doesn’t stop the misinformation from flowing, usually based on poorly-conducted studies that don’t even pass the most basic sense-check from interested readers, even non-experts who decide to read behind the headlines.
A great example of this is a study published in 2018, with none other than Stanton Glantz as senior author, which looked at data from the 2014 Eurobarometer survey and concluded:
On the population level, the net effect of the entry of e-cigarettes into the European Union (and Great Britain) is associated with depressed smoking cessation of conventional cigarettes.
This conflicts with tons of research from around the world, and it’s unsurprising that there was something wrong with the analysis. That’s why Dr. Farsalinos and Anastasia Barbouni published a new study based on the 2017 version of the same survey, improving the analysis and – shockingly enough – coming to a completely different conclusion. They found that current or former daily vaping was positively associated with recently having quit smoking.
So what’s going on here? Why have the two studies come to such different conclusions?
The Older Study
The study based on the 2014 Eurobarometer survey looked at the data in a fairly basic way. The researchers looked at all ever-smokers in the survey sample, and compared those who’d ever regularly vaped with those who’d never vaped in terms of their odds of being a former smoker. They found that whether looking at daily, occasional or experimental vaping, the odds of being a former smoker were lower in those who’d vaped compared to those who hadn’t.
The big issue with this finding is that vaping hasn’t been around forever. While it was certainly possible to get e-cigarettes in 2009, say, it didn’t really take off until much later, and the authors didn’t consider how long it had been since the former smokers had quit. Many ex-smokers in the group probably quit smoking before vaping was even available, which biases the results when compared in such a simple way. It creates an artificial abundance of ex-smokers who quit without vaping, not because vaping doesn’t work, but because the option wasn’t even available for many of them.
The New Study – Updating and Improving the Analysis
This is where the new study comes in. The researchers looked at the 2017 Eurobarometer survey, with over 13,000 current and former smokers in the sample, from across the EU. They took note of some sociodemographic factors like age, gender, social class and education, looked at the participants’ smoking statuses, and broke them down into daily, occasional and never-vapers, also noting whether they still vaped or had stopped at the time of the survey.
The basic idea was to conduct the same analysis as in the previous study, except accounting for the quit duration in the analysis. So rather than lumping all ex-smokers together, no matter how long they’d quit for, the researchers grouped them into former smokers of less than two years, three to five years, six to ten years and over ten years.
Vaping is Linked to Recent Quitting
The headline finding from the study is that vaping is linked to recent quitting throughout the study. Former smokers who quit over 10 years ago rarely vaped, while people who quit smoking in the past five years were substantially more likely to be vapers than any other group. Overall, daily vapers were five times more likely to have quit between 2015 and 2017, and three times more likely to have quit between 2012 and 2015. These figures are based on the mathematical models used in the study and in comparison to people who’ve never vaped. If you look at quitters in general – without considering how long ago they quit – vapers were still 50 percent more likely to have quit smoking.
On the other hand, occasional vaping wasn’t associated with having quit in the previous five years, and there was a negative association with having quit 6 or more years before the study (i.e. people who were occasional vapers were less likely to have quit that long ago). This is basically what the older study found, but the explanation is obvious: very few people vaped before 2011, so it makes perfect sense that vapers would be much less likely to find themselves in this group.
So overall, the results of the study show a clear link between having quit smoking recently and being a vaper – if you vape, you’re more likely to have quit smoking recently than somebody who hasn’t. Of course, this is an association and doesn’t conclusively prove that vaping helps people quit smoking. However, to reject that idea you have to reject a lot of other evidence too, so if you take everything we know into account, this is another clear sign that vaping is helping people quit smoking. It’s also entirely possible that they quit smoking before starting to vape (because the survey doesn’t have information about which came first) but again this is fairly unlikely based on what we already know.
Former Smokers Aren’t Starting to Vape
One of the less frequently repeated objections to vaping is that people who’ve already quit smoking might start vaping as a way to relapse. Kind of like a “gateway back” hypothesis – they could get re-addicted to nicotine through vaping and end up smoking again. Thankfully, though, the study provides pretty good evidence that this isn’t happening.
Firstly, 97.7 percent of people who quit smoking over 10 years prior to the survey had never vaped, and only 0.2 percent vape daily. For people who quit between 6 and 10 years before the survey, only 1.4 percent were daily vapers, and 91.4 percent had never vaped.
This might not be the most surprising finding to people who are already familiar with vaping and aren’t specifically looking out for any argument that could be used to oppose vaping, but it’s still good to get confirmation. Of course if you’ve quit smoking there’s little reason to want to vape. It’s even possible that former smokers at risk of starting again might take up vaping instead and never end up smoking – the study doesn’t give evidence of this, but it’s an interesting possibility nonetheless.
E-Cigarettes Aren’t Stopping People in Europe From Quitting
If you’ve kept up with the research into vaping, this study doesn’t tell you anything new, but it does add more evidence of something a disappointing number of people have trouble accepting: vaping is an ally in the fight against smoking-related disease and death. The previous study attempted to play into these fears by lumping people who quit smoking long before vaping was popular in with those who could feasibly have used vaping to quit. But when you look at the data in more detail, it’s unavoidably clear that smokers are using e-cigarettes as a quitting aid, and it’s very likely that they’re useful as a quitting aid. These conclusions are only bolstered by the substantial sample size of over 13,000.
So – shock horror – Stanton Glantz produced another flawed piece of research with results aligned with his ideological goals. The problem of how much undue attention his research gets is still a serious one, but the more we can counter it with direct refutations like this, the better.