English adults who smoke are increasingly unaware that vapes are less harmful than cigarettes, new data reveal. That’s in a country where vapes have been broadly welcomed, and embraced as harm reduction by official messaging—but one where media and policies have more recently muddied the picture.
More than 28,000 adults in England who smoke were quizzed on how they perceived vapes between November 2014 and June 2023. A study presenting the outcomes, published in JAMA Network Open on February 28, concluded that: “harm perceptions of e-cigarettes have worsened substantially over the last decade.”
In 2014, 44 percent of participants correctly said that vaping was less harmful than smoking. But by 2023, only 27 percent knew this—a 40 percent decline in understanding.
In 2023, the most common belief was that cigarettes and vapes were equally harmful (34 percent), while 23 percent thought vapes were more harmful.
The big problem here is self-evident.
“If smokers think vaping is equally or more harmful for them than smoking, this may put them off trying to switch to vaping or from using e-cigarettes in a quit attempt, which might keep them smoking for longer,” Sarah Jackson, one of the study authors and a principal research fellow at University College London’s Institute of Epidemiology & Health Care, told Filter.
People’s general mistrust for vapes is partly due to the fact they’re still relatively new products, she continued, and health information can take a long time to filter through at a population level—as we saw, for example, with public understanding of the harms of smoking.
“But what they need to understand is that the science has moved on a lot since then,” she said, “and if cigarettes were developed today we would know immediately that they were incredibly harmful.”
Asked what caused the decline in trust for vapes, Dr. Jackson said the data the study provided could not answer this. However, as the study noted: “The timing of the 2 most notable changes in harm perceptions coincided with the e-cigarette, or vaping product, use-associated lung injury outbreak [“EVALI”] in 2019 and the recent increase in youth vaping in England since 2021.”
“The blame lies with the constant flow of misinformation, scare stories and doubt.”
Clive Bates, a tobacco harm reduction advocate and a former director of Action on Smoking and Health (ASH, UK), was unequivocal about the reasons for the decline. “The blame lies with the constant flow of misinformation, scare stories and doubt that starts in universities, which is amplified by activists and then ends in the media,” he told Filter.
The United Kingdom has long been known for embracing the science to convey the message that vaping is far less harmful than smoking.
As well as the fact of vapes being widely available at retail outlets, this has been reflected by the National Health Service (NHS) acknowledging that vaping is an effective smoking cessation strategy, and by policies such as the government’s ”swap to stop” scheme, offering free vape kits to 1 million people who smoke. Local programs have included councils offering free vapes for smoking cessation during pregnancy.
But this harm reduction messaging has increasingly been blurred by media outcry and now, by policies. In January, Prime Minister Rishi Sunak announced a ban on disposable vapes and new powers to restrict flavors, aimed at reducing youth vaping. A planned vape tax is expected to be introduced in the upcoming national budget.
“Bans, restrictions and taxes also play into risk perceptions of vapes, even if their intent is to restrict youth uptake,” Bates said. If the government bans vapes or imposes cigarette-like restrictions, he continued, “Why wouldn’t people think the authorities are doing it to protect them from similar risks?”
As a result of all this, the British public’s knowledge of the relative risks of vapes and cigarettes appears to be heading in the direction of the United States—where misinformation, including from health authorities, has kept public awareness even lower.
Photograph via PxHere
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