Views on vaping safety have changed following reports of lung damage

In the United States, adults increasingly perceive electronic cigarettes, or e-cigarettes, as “more harmful” than traditional cigarettes, according to a new study published this month in the American Journal of Preventive Medicine.

Additionally, the percentage of people who exclusively used traditional cigarettes nearly doubled between 2019 and 2020 among those who perceived e-cigarettes as more harmful, rising from 8.4% in 2019 to 16.3% in 2020.

“We were able to show that these changes in perception potentially changed behaviors at the population level,” said Priti Bandi, PhD, senior scientist at the American Cancer Society in Atlanta and lead author of the study.


Dr. Priti Bandi

Since e-cigarettes entered the US market in 2006, public health experts have questioned manufacturers’ claims that the products work as a harm reduction tool to help traditional cigarette smokers quit smoking. . The public perception is generally that e-cigarettes are safer for a person’s health. While research is still emerging on the long-term health outcomes for users, public opinion has shifted since the devices were introduced.

The new study showed a sea change in public perception of e-cigarettes following media coverage of cases of users presenting to the emergency room with mysterious lung symptoms in 2019. The Centers for Disease Control and Prevention finally found what is now called e-cigarette or vaping product use-associated lung injury (EVALI) was linked to vitamin E acetate, an additive to THC-containing products, but not nicotine.

The CDC’s latest update came in February 2020, shortly before the COVID-19 pandemic swept through the United States, prompting a dramatic shift in investigating the novel virus among health care providers and Researchers.

Bandi and colleagues collected 2018-2020 data from a National Institutes of Health database called the Health Information National Trends Survey, a nationally representative cross-sectional mail-in survey of American adults and their attitudes towards cancer and health-related information. More than 3000 people every year answered questions about e-cigarettes.

The study found that the percentage of people who thought e-cigarettes were more harmful than traditional cigarettes had more than tripled, from 6.8% in 2018 to 28.3% in 2020. Fewer people also considered e-cigarettes electronic cigarettes as less harmful than traditional cigarettes, increasing from 17.6% in 2018 to 11.4% in 2020. Fewer people also said they did not know which product was more harmful.

Among those who thought e-cigarettes were “relatively” less harmful than traditional cigarettes, e-cigarette use increased from 15.3% in 2019 to 26.7% in 2020.

The implications

According to Bandi and other experts, the key finding that people started smoking cigarettes when they thought e-cigarettes were more harmful should be a wake-up call for public health officials and doctors who communicate the health risks to patients.

Messaging should be more nuanced, Bandi said. Many adults use e-cigarettes as a cessation tool, and she and other experts point to research that shows the products are, at least in the short term, less harmful, especially as a smoking cessation tool. Vapes are among the most popular tools people use when they want to quit smoking — with the majority of American adults using vapes partially or completely to quit smoking, according to the CDC.

Some countries, like England, are set to allow doctors to prescribe e-cigarettes to help reduce smoking rates. Regulators in the UK said in 2021 that they were considering allowing the licensing of devices to be used to quit smoking.

“There is an absolute need for continued and accurate communication from targeted public health authorities to the appropriate audiences,” Bandi said.



Dr. Ashley Brooks-Russell

Ashley Brooks-Russell, PhD, MPH, associate professor at the Colorado School of Public Health in Aurora, said the finding that perceptions can change behavior is good news. However, the bad news is that adults have overcorrected and switched to cigarettes, which are proven to cause cancer and other health problems.

“We’re good at public health at getting the message out that cigarettes are bad, that tobacco is broadly harmful,” Brooks-Russell said. Medscape Medical News. “We’re really bad at talking about lesser options, like if you go for a smoke, e-cigarettes are less harmful.”

But other health leaders warn that e-cigarettes could produce the same or even worse adverse health effects than cigarettes. The only way for researchers to get a conclusive answer is decades into a patient’s life. Until then, it is unclear whether the potential benefits of quitting smoking will outweigh the risks.



Kevin McQueen

“This research should remind health care providers to know what products patients are using, how much, and whether those patients experience any health issues later on,” said Kevin McQueen, MHA’s senior respiratory director at Health System. the University of Colorado and president of the Colorado Respiratory. Care company.

“What worries me is that even though people are starting to think e-cigarettes are more dangerous, some people still think they’re safe – and we don’t know how much safer they are,” did he declare. “And we won’t know for 10, 15, 20 years.”

All authors were employed by the American Cancer Society at the time of the study, which receives grants from private and corporate foundations, including foundations associated with healthcare companies for research outside of the submitted work. The authors are not funded by or by key personnel on any of these grants, and their salaries are supported solely by funds from the American Cancer Society. No other financial information was reported.

Bitter J Prev Med. Published online June 8, 2022. Full text

Kelly Ragan is a Colorado-based writer and editor.

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