Thursday, September 21, 2023

 

E-cigarettes are not a gateway into smoking


Peer-Reviewed Publication

QUEEN MARY UNIVERSITY OF LONDON



The most comprehensive study to date investigating whether e-cigarettes are a gateway into or out of smoking finds that, at the population level, there is no sign that e-cigarettes and other alternative nicotine delivery products promote smoking.

The study, led by Queen Mary University of London and funded by the National Institute of Health and Care Research (NIHR), also found some evidence that these products compete against cigarettes and so may be speeding up the demise of smoking, but this finding is only tentative and more data are needed to determine the size of this effect.

The study compared the time course of use and sales of electronic cigarettes with that of smoking rates and cigarette sales in countries with historically similar smoking trajectories, but differing current e-cigarette regulations. It compared the United Kingdom and United States with Australia, where sales of nicotine containing e-cigarettes are banned. It also looked at interactions between smoking and nicotine alternatives that are popular in other countries, including the use of oral nicotine pouches in Sweden and products that heat rather than burn tobacco in Japan and South Korea where they are widely used.

The decline in smokers in Australia has been slower than in the UK, and slower than in both the UK and the USA among young people and in lower socioeconomic groups. The decline in cigarette sales has also accelerated faster in the UK than in Australia. The increase in heated tobacco product sales in Japan was accompanied by a significant decrease in cigarette sales.

Researchers note that because people may use both cigarettes and alternative products, prevalence figures for these products overlap, and so longer time periods are needed to determine any effects of exclusive use of the new products on smoking prevalence. They also say that the indications that alternative nicotine products are replacing smoking – especially the size of this effect – need to be confirmed when more data become available. As further prevalence and sales data emerge, the analyses will become more informative.

Professor Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, said:

"The results of this study alleviate the concern that access to e-cigarettes and other low-risk nicotine products promote smoking. There is no sign of that, and there are some signs that they in fact compete against cigarettes, but more data over a longer time period are needed to determine the size of this effect."

Co-author, Professor Lion Shahab, Co-Director of the UCL Tobacco and Alcohol Research Group, said:

"This comprehensive analysis provides reassurance that countries which have adopted a more progressive stance towards e-cigarettes have not seen a detrimental impact on smoking rates. If anything, the results suggest that - more likely than not - e-cigarettes have displaced harmful cigarettes in those countries so far. However, as this is fast moving field, with new technologies entering the market every year, it remains important to continue monitoring national data."

Professor Brian Ferguson, Director of the Public Health Research Programme (NIHR) commented

"The initial findings from this study are valuable but no firm conclusions can be drawn yet. More research is needed in this area to understand further the impact that alternative nicotine delivery products, such as e-cigarettes, might have on smoking rates.”

This research, published in the journal Public Health Research, was funded by the National Institute for Health and Care Research. 

END

NOTES FOR EDITORS

  • Pesola F, Phillips-Waller A, Beard E, Shahab L, Sweanor D, Jarvis M, Hajek P. Effects of reduced-risk nicotine-delivery products on smoking prevalence and cigarette sales: the GIRO observational study. Public Health Res 2023;11(XX). https://doi.org/10.3310/RPDN7327
  • For more information on this release, to receive a copy of the paper or to speak with the researcher, please contact Laurence Leong in Queen Mary’s press office: l.leong@qmul.ac.uk

About Queen Mary University of London

At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.

Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers.

Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro.

We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form.

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

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About the University of Ottawa 

Rooted in our bilingual and Francophone DNA, we are evolving at the intersection of many cultures. Located in Canada’s capital, a gateway to the world, we possess a unique platform to respond with energy, creativity, and scale to the global challenges and opportunities our world offers. With an active focus on equity, diversity, and inclusion, we will thrive like never before. 

Already in this new millennium we have rocketed into the top 1% of the world’s 20,000+ universities with our research reputation. We have doubled our enrolment with students from across Canada, as well as from 147 countries around the globe, choosing uOttawa. 

Our international influence is surging, with institutional partnerships in Europe, Asia and Africa multiplying rapidly – including membership in the U7 Alliance of world universities. 

Meanwhile our research and programs in Cybertech, health, science, social justice, sustainability, education, and entrepreneurship continue to impact communities across Canada and around the globe every single day. Our scientists and academicians are driving progress in ethical AI and technology development, in clean growth and innovation and in action- oriented research on aging, active and healthy living, lifelong learning, and well-being, to name but a few. 

At uOttawa we are driven by the urge to challenge the status quo, the will to make an impact, and the ambition to become a catalyst for change.

About The National Institute for Health and Care Research (NIHR)

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

· Funding high quality, timely research that benefits the NHS, public health and social care;

· Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

· Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

· Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

· Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

·  Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

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