Vaping: for and against

A smoking cessation expert has called for vaping to be made available for adults as a quitting aid

UNSW Conjoint Associate Professor Colin Mendelsohn, chairman of the Australian Tobacco Harm Reduction Association, has written to the Medical Journal of Australia to state that nicotine vaping does not cause young people to take up smoking tobacco.

Recent international reviews show that vaping is actually doing the opposite and diverting adolescents away from smoking, he says.

“As vaping rates have been increasing in young people, smoking rates are rapidly declining,” he says.

“This is inconsistent with claims that vaping causes young people to take up smoking. If there is an effect, it is very small.”

He says international studies show most vaping by young people is experimental and short-lived, and regular vaping in teenagers is almost exclusively confined to those who already smoke.

“A recent analysis of five national surveys of 60,000 adolescents in the United Kingdom, where e-cigarettes are legal and widely available, found that less than 0.5% of 11 -16 year olds who had never smoked were regular vapers (at least weekly),” he says.

He says recent studies in populations in the US and UK have found that daily use is associated with higher success rates of quitting smoking than among non-users.

“Banning wider access to e-cigarettes on the basis of the unproven, potential risk to adolescents would prevent access to a life-saving quitting aid for millions of smokers,” says Associate Professor Mendelsohn.

“A better solution would be to employ strategies to minimise youth access and make vaping available for adult smokers who are otherwise unable to quit smoking with conventional therapies.”

He says it would be a “mistake” to wait until “total scientific certainty” has been achieved regarding harms from vaping compared to traditional tobacco smoking.

Also in this week’s MJA, news and online editor Cate Swannell took a look at research published in JAMA last week, in which more than 100,000 adults were asked about their lifetime use of e-cigarettes.

The research found that although more people were trying vaping at least one time in their lives, there had actually been a reduction in the number of consumers who then went on to use the devices on a regular basis.

“In a nationally representative survey among US adults, there was a significant increase in the prevalence of ever use of e-cigarettes between 2014 and 2016,” the authors wrote.

“In contrast, the prevalence of current e-cigarette use among US adults declined significantly between 2014 and 2016.”

Ms Swannell spoke to Professor Mike Daube from Curtin University, who said that the JAMA research suggested health stakeholders were “right to be cautious” about the devices.

“The evidence for cessation benefits is at best limited; the evidence for concern about use by non-smokers (including children and young people) is now very substantial; and there are also increasing concerns about a range of health harms,” he told MJA InSight.

Nicotine-containing liquids for use in e-cigarettes remain unapproved by the TGA in Australia.

Last year, Health Minister Greg Hunt told Triple J that he was against any change in this decision.

“There is clear evidence that it’s likely to lead to the uptake of cigarettes, cigarette smoking, it creates the habit from around the world,” he told Hack reporter Sarah McVeigh.

“It’s not going to be happening on my watch as far as I’m concerned.”

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