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There is no transparency about how this group was selected. But this was plainly not a group which was ever likely produce a consensus that was anything but glowing about e-cigarettes. A far more likely scenario — as I will argue — is one that sees a continuing stream of smokers quitting mostly unaided as they always have; significant numbers attributing their quitting to e-cigarettes; but a slowing in overall quit attempts as many dual-using vaping smokers keep smoking at reduced rates, in the erroneous belief that they are reducing harm.

The quality of evidence we have for declaring e-cigarettes to be benign has been described in another review as very poor. A review concluded:. Due to many methodological problems, severe conflicts of interest, the relatively few and often small studies, the inconsistencies and contradictions in results, and the lack of long-term follow-up, no firm conclusions can be drawn on the safety of ECs [e-cigarettes].

However, they can hardly be considered harmless. The health problems caused by tobacco develop over decades. Every year will bring us more and more information about what the consequences of the typical daily vaper inhaling nicotine, propylene glycol, and an unregulated cocktail of fine and ultra fine particles like flavouring agents approved for ingestion in foods but not for inhalation an average times a day 43, times a year. We will also see what the International Agency for Research in Cancer has to say about whether nicotine is carcinogenic, having declared in its assessment to be one of its priorities.

Their data are of great importance because by distinguishing daily from non-daily vapers, they allow the differentiation of casual and experimental users from daily users. Their study also provides data on outcomes 12 months later. This simultaneous increase in e-cigarette use and cessation may be coincidental, and it is therefore vitally important for longitudinal studies to be conducted to assess the impact of e-cigarette usage on quitting behaviour.

Daily use of e-cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non-daily use of e-cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking. A companion paper broke down the data further by type of e-cigarette product. Daily tank system users were the only group which showed a significant improvement in smoking cessation.

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But of 1, smokers followed up at 12 months, only 69 — just 4. And just over one in four of these — only nineteen or 1. This is hardly the stuff of revolutionary dreams for population-wide cessation! While the McNeill group has reported that smoking cessation rates were the highest since at least , the latest data from August in the Smoking Toolkit study show the lowest percentage of English smokers trying to quit since These two data sets thus appear to show quite different, perhaps incompatible results about the proportion of smokers making cessation attempts and actual cessation.

Greater clarity on this key issue is badly needed. Many vaping advocates downplay this gigantic elephant in the room with fingers-crossed optimism that dual use should always be seen as just a transitory phase that smokers go through before they quit smoking. As I will argue soon, the tobacco industry has other ideas about this. The Brose et al paper from England reported that at 12 months, Even among those smokers who vaped daily, There is a dose-response relationship that no one disputes here: those who smoke more are more likely to die from their smoking than those who smoke less.

But this is quite a different claim. Four cohort studies published since have reported on whether reducing smoking, as opposed to stopping smoking altogether, confers any mortality benefit. A Norwegian cohort of 51, people followed from the s until found:. A Scottish study of two cohorts followed from the s to also found no evidence of reduced mortality in reducers, but clear evidence in quitters. It concluded that:. Vapers who keep on smoking — which is most of them — are fooling themselves if they think they are seriously reducing risk.

I now turn to the future of vaping. All they care about is their unhindered access to unregulated vape gear and their rights to vape anywhere: in workplaces, next to you on planes, and presumably while driving the school bus, inside child care centres and hospitals.

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In England, vaping by non-smoking kids is very uncommon. Nearly everyone thinks that is self-evidently a good thing. But the same cannot be said about the United States where data from the US National Youth Tobacco Survey show that while cigarette smoking continues to fall ammong US teenagers, e-cigarette use has been dramatically increasing since Apologists for teenage vaping actually try to argue that this is a good development! You see, all those teenage vapers would have been smoking were it not for e-cigarettes. The small problem here is that this rise was not associated with a rise in dual or multiple tobacco or nicotine product use, and the decline in cigarette smoking had been falling before e-cigarettes arrived.

But as yet they have not.


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Nearly all businesses survive and flourish by retaining existing customers and critically, stimulating new customers to start. But if you are selling products which have potential to be used by more than those already using them, you are vitally interested in non-users. Cigarette and e-cigarettes fit that description perfectly. For decades the tobacco industry told us — and still does — that it is not the least bit interested in teenage smoking.

The global e-cigarette market today is a mixture of big tobacco-owned brands and those owned by start-up incumbents. The tobacco industry is rapidly acquiring those minnows it regards as likely to be most profitable and strategic. Wide-eyed vaping advocates would have us seriously believe that the tobacco industry, with its billions of dollars in assets and long history of acquisitions, will not somehow soon swallow up most of these just as it did small tobacco companies all over the world.

No tobacco company currently acquiring e-cigarette brands is desisting in any way from attacking effective tobacco control. Plain packs are being attacked. Every day BAT bleats on Twitter about how high tobacco tax — the most important plank in comprehensive tobacco control — is causing more illicit trade. The message is clear: taxes should be lowered, to make smoking more affordable and to arrest brutal falls in smoking. Quite obviously, this is not an industry which wants smokers to stop smoking. And guess what?

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