Learn How E-Cigarettes Are Changing The UK’s Smoking Habits

Are you new to e-cigarettes, or deciding on changing your smoking habits for a better life?

Cited as the most popular quitting aid in England, e-cigarettes are a viable choice for existing smokers who wish to give up, even the NHS agree. With just 15.5% of adults in England using tobacco on a regular basis, the rate of smokers in the country has hit an all-time low, partly due to the widespread availability of vaping products.

E-Cigarettes UK

Despite this, smoking is still the leading cause of preventable illness and premature death in England. With a significant number of people still developing smoking-related illnesses, the Government has issued an updated Tobacco Control Plan, designed to deter people from taking up smoking and encourage existing smokers to quit.

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In this season of good will and peace to all…

In this season of good will and peace to all men and women, I thought that it would be remiss of us to not take the time out to reflect and share the events as they unfolded on the day that our Chief Scientific Officer, Lucy Robins, was invited to speak on Sky News about battery safety.

As members of the IBVTA, whose head office staff were in the midst of an office move, we received a call from Garry Dibley who asked if we could put anyone forward.  The timing of this seemed to be perfect as the IBVTA had finished their guide to battery safety only this week and was circulating it for sign off so we agreed to the interview.

Battery safety is something that not only affects our industry, but wider society.  In September of this year I was shocked at my own ignorance to learn of the threat that ‘button’ batteries pose to small children if swallowed. Battery safety is something that has always been on the agenda for us when selecting products, especially now that we are manufacturing our own range of hardware however the rise of rechargeable, replaceable 18650  batteries over more recent years to power the bigger devices being marketed brought this issue to the fore.

The interview was in response to a newly released video by the Fire service, showing a battery discharging in a man’s pocket after it was carried loose with coins. So in preparation we scoured the internet for media coverage.  In order to gauge the tone of reporting we checked the big hitters (or usual suspects) first.  The Daily Mail’s report was succinct and factual.  No undue hyperbole.  Not a reference to the morality of vaping or how vaping is a gateway to smoking or whether adults have the right to choose sweet flavoured e-liquid.  They pretty much recanted the core message.  Carry batteries safely and be aware of the dangers if not.

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Global Forum on Nicotine 2016

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The Global Forum on Nicotine (GFN) has been attracting stakeholders from around the globe for the past three years with GFN 2016 having participants from 44 countries including policy analysts, regulators, academics and researchers. The agenda for the conference brought together key industry professionals to present their research and hold rigorous and honest debates on a wide range of topics regarding nicotine and e-cigarettes. Liberty Flights Ltd. was represented by IBVTA (Independent British Vape Trade Association), and below we have summarised the presentations of interest from a few key speakers at the event.

Dr Lynne Dawkins (London South Bank University, UK)

One of the speakers at this event was Lynne Dawkins who has been conducting research into e-cigarettes since 2010, her most recent study which she presented at the GFN was ‘Compensatory puffing behaviour in e-cigarette users’.

As we all know in Article 20 of the TPD (Tobacco Products Directive) nicotine strength is limited to 20mg/ml and, around 9% of all of e-cigarette users currently use above that concentration. The experiment was to determine whether e-cigarette users self-titrate when given a lower concentration of e-liquid, to compensate for the reduced nicotine.

What is self-titration?

E-cigarette users adjust their nicotine intake to maintain a personal optimal level in their system, this is usually achieved by puffing on the device for a couple of seconds longer or taking a few short, additional puffs straight after just to get that right hit.

Study Design

Two concentrations of e-liquids were used in this study one at 6mg/ml and the other at 24mg/ml, and there were a total of 11 e-cigarette users. All 11 participants followed the same procedure throughout the study which was repeated for both the lower and higher concentrations for each participant.

The results published show that puff duration, amount of puffs and the volume of e-liquid consumed was approximately twice as much in the lower nicotine strength compared to the higher nicotine strength.

Do papers ‘puff’ less when it comes to higher nicotine?

Yes. The results from this study show that the mean puff number for 24mg/ml was approximately 50% lower than for 6mg/ml. From this we can see clear evidence of compensatory puffing when a lower nicotine e-liquid is used. The mean volume of 24mg/ml nicotine e-liquid consumed was also approximately 50% lower.

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Fig 1. Puffing Topography

Is there a difference between hit and satisfaction when varying nicotine concentrations?

During the study participants rated the hit and satisfaction they got when using each e-liquid strength. The general trend is that users get approximately a 63% hit and satisfaction rating in the 24mg/ml, compared to 47% if it is a 6mg/ml e-liquid.

Positive-Effects-Liberty-Flights-Lynne-Dawkins

Fig 2. Hit and Satisfaction differences.

Using this data, we can see the possible unintended consequences of the TPD regulations. New users that require that extra hit and satisfaction will find it even more difficult with nicotine concentrations below the 20mg/ml limit. This will generally make it harder for users to replicate the strong hit and satisfaction from traditional smoking which in turn may impact successful quit attempts.

Dr Christopher Russell (Centre for Substance Use Research, UK)

Christopher Russel Ph.D. focused his research on ‘how vapers help smokers quit’. Vaping anecdotes, when supplied on mass can become a reliable and credible source of information. This study focused on what users could do to help the next person quit, by sharing success stories and the benefits of vaping over traditional smoking.

E-cigarette users in Great Britain

In 2015, 2.2 million people in Great Britain used an e-cigarette, of which approximately 38% had switched completely away from smoking to vaping. However, there are still 36% of smokers in Great Britain who have not yet tried using an e-cigarette. This shows there is a large potential to persuade more smokers to try e-cigarettes ultimately reducing tobacco related harm.

What benefits of using e-cigarettes are experienced by users?

In this questionnaire, a total of 200 participants were asked to select any of 83 listed potential health benefits and harms of switching to e-cigarettes. At the time of the study participants had not smoked traditional cigarettes for around 14 months with 96% vaping everyday using 1 to 12mg/ml e-liquid.

Benefits-of-using-ecigarette-Christopher-Rusell

Fig 3. Changes experienced since users started vaping.

The figure above shows participants listed an improvement in their respiratory health as the top benefit from switching to e-cigarettes. Other benefits included improvements to mood, sleep and hygiene. Information like this could be instrumental in influencing a smoker’s decision to try e-cigarettes and ultimately switching completely.

What are the main reasons for e-cigarette users quitting?

Every e-cigarette user has their own personal reason for quitting, and the well-known risks attached to smoking lead many people to reduce if not quit completely. The figure shown below is users reasons for first trying an e-cigarette.

Why-User-Quit-Christopher-Rusell-Liberty-Flights

Fig 4. Reasons for switching.

The cost saving implications, smell and social stigma of smoking are just a few of the reasons many have made the switch, and this should now be relayed back to smokers that are aspiring to quit just to give them that extra push. However, they should be made aware not to expect miracles when switching and that the change can be slow before they quit the habit completely.

What possible advice can be given to smokers aspiring to quit?

A lot of e-cigarette users are experienced and knowledgeable in the potential benefits of e-cigarettes over traditional smoking already and this can be used for the benefit of traditional smokers to help them quit. Many smokers want to hear vapers stories and experiences of using an e-cigarette before making the leap. In this study participants were asked what advice they would give someone looking to make the switch and we have chosen a few examples.

‘Every cigarette less is an achievement: going again after a slip is a bigger achievement.’

 ‘Small steps taken with purpose are better than impractical giant leaps.’

‘Define yourself by your achievements not your failures.’

‘If you smoke, don’t beat yourself up, it happens. Just go again.’

 Further motivational advice can be found on Dr Christopher Russell YouTube channel: youtube.com/vapershelpingsmokerstoquit

Neil McKeganey (Centre for Substance Use Research, UK)

Are e-cigarettes a gateway to smoking or a roadblock?

This topic is much discussed leading many people outside of the e-cigarette community to have the misconception that e-cigarettes act as a gateway to smoking. Neil McKeganey in his presentation, shed some light on this divisive issue.

Neil McKeganey carried out a study in which 120, 16-28 year olds were interviewed. This study focused on the perception of e-cigarettes in the younger community, the initiation of trying an e-cigarette and the perception of harm from e-cigarettes.

What do e-cigarette users have to say?

Below are some examples of questions and answers recorded during the study.

Question: What would happen if you couldn’t vape?

Answer: I would probably smoke to be honest.

Question: Would you say it is as harmful as cigarettes?

Answer: I wouldn’t say it was as harmful as cigarettes as I would say that smoking cigarettes is really bad in that other people around can get affected. Vaping wouldn’t affect others as much because it isn’t as harmful as smoking.

Conclusion

Most young people interviewed in this study saw vaping and smoking as being associated with very different harms. The predominant view within this study was that vaping had made smoking less attractive rather than more attractive implying that it is not a gateway to smoking. It may even be a gateway out of traditional smoking.

——————-

Minhaaz Dadabhai

Scientist

 

References

https://gfn.net.co/downloads/2016/Lynne%20Dawkins.pdf

https://gfn.net.co/downloads/2016/Christopher%20Rusell.pdf

https://gfn.net.co/downloads/2016/Neil%20McKeganey.pdf

YouTube: Vapers Helping Smokers to Quit.

The Real Story About Vaping And Your Health

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ASH (Action on Smoking and Health) has partnered with YouGov to conduct surveys about the use of tobacco products for many years. Starting on 2012, they began taking data for those who vape (use electronic cigarettes) exclusively, either as a replacement for or alternative to traditional cigarettes or other tobacco products. Now that they have amassed a few years’ worth of detailed data, they have made some very interesting findings. Their results might even surprise some of you.

In short:

  • Nearly 3 million adults throughout the UK vape, up more than 2 million in the last 4 years.
  • Just under half of vapers are ex-smokers, who now use e-cigarettes exclusively.
  • Vapers say that they use e-cigarettes to either cut down on or replace traditional smoking entirely, mostly for health reasons.
  • More than ¾ of vapers prefer using e-liquids with relatively low nicotine loads.
  • Nearly ¾ of vapers use less than 4ml of e-liquid per day.
  • Vaping is nearly non-existent among those who have never smoked.

And yet…

  • Only 15% of the public believes that vaping is substantially less harmful to one’s health than smoking, despite evidence to the contrary.

…But of course, the devil is always in the details. Let’s take a deeper look at these results, and what they really mean.

How effective is vaping when it comes to replacing traditional smoking?

Virtually everyone today knows how devastating smoking can be to your health, and to the health of those around you – cancer, COPD and emphysema are just the beginning. So, one of the things proponents of vaping point to as a positive effect is its ability to replace smoking either as a pathway to reducing nicotine intake or as a way to smoke less (and thereby avoid at least some of the harmful effects). This is the same argument used for nicotine gum or patches.

So, what does the report say about vaping helping people to quit smoking?

liberty-flight-table-one-real-story-of-vaping-and-your-health

The ASH results would suggest that vaping can help people quit tobacco. 1.3 million UK residents today no longer smoke traditional tobacco products due to switching to vaping exclusively. A further 1.4 million vapers also use traditional smoking products, but use substantially less because they have access to vaping.

In all, there is definitive proof that some 1.8 million Britons smoke less today because of vaping.

Do smokers really seek out vaping as a way to quit smoking?

liberty-flight-resons-for-using-electronic-cigarettes-among-users

Yes. The ASH survey shows that the three most common reasons UK residents vape are:

  • To stop smoking entirely,
  • To spend less money (than they did on smoking), and
  • To keep themselves off tobacco (after quitting).

What about the argument that vaping will be adopted by non-smokers, causing them to become nicotine users and perhaps transition to traditional smoking?

That was always the biggest argument against vaping – that it would cause young people to become nicotine users and perhaps smokers. The fact is, though, that only 0.2% of vapers had never been smokers – a figure that has not increased measurably in more than 3 years.

Does the public understand that vaping is substantially less harmful than smoking?

Not according to the ASH survey. There is a great deal of misunderstanding on this point, and the number of people who correctly identified vaping as the substantially less harmful option is actually falling.

liberty flights perception if harm

Despite a lot of good science being published on the subject, and organisations like the NHS supporting vaping as a less harmful alternative to smoking, the public is largely uncertain about the relative risks.

Only 15% of those asked got it right – that vaping was ‘a lot less harmful’ than smoking.

Do smokers understand the lesser risk of vaping?

Again, many do not. The top reason listed for why smokers who have never vaped have never tried it is that they are worried that it might not be safe – at 27%. Meaning that up to a quarter of current smokers may potentially try vaping as an alternative to smoking if they really understood the risks!

Can vaping be a pathway to quitting nicotine entirely?

The Ash results say yes. 10% of vapers use an e-liquid that has no nicotine in it at all. 37% of vapers use concentrations of 8 mg/ml or less. Only 9% use e-liquids at of 19 mg/ml or higher.

What is the significance of the ASH survey showing such positive results about vaping?

Frankly, the results of the latest ASH survey are a very big deal for the vaping community, and the businesses that serve it. In the early years, ASH was heavily against vaping in all forms and in all ways, and there was a great deal of concern from both the Government and the medical community. They used to feel that Britain would be better off without e-cigarettes in it at all. Of course, that has all changed now.

Vaping supporters have been convinced all along of the health benefits of switching from smoking to vaping. As more and more accurate scientific investigations into the actual health effects of vaping as opposed to smoking have been made, we are pleased to see acknowledgement of the positive role vaping can play in the lives of ex- smokers and those still trying to quit.

What is the biggest challenge to vaping being accepted as a real, effective and healthier alternative to smoking?

The biggest stumbling block for vaping is misguided public opinion and outright disinformation about its relative safety, and its usefulness to those who are struggling to quit smoking. However, as more health and governmental bodies change their policies to support vaping as a healthier alternative to smoking, we can expect public opinion to follow suit.

For more information and in-depth analysis see link below.

References: http://www.ash.org.uk/files/documents/ASH_891.pdf

Thank you,

Liberty Flights Team