How much better for you is vaping to smoking?

In recent weeks several newspapers, including the Daily Mail, the Mail on Sunday, the Daily Star and The Sun have all run articles claiming as few as ten puffs of an e-cigarette can increase your risk of heart disease and may even make smokers less likely to quit. The findings stem from a Karolinska Institute study, and come in spite of the fact Public Health England has publicly stated vaping is 95 per cent safer than tobacco.

But closer scrutiny of the Karolinska Institute's findings by Spectator Health have shown up a series of shortcomings (see below), which undermine the study's conclusions:

"This was a small study of 16 healthy volunteers to assess possible harms of using electronic cigarettes on blood vessels. There were two groups, randomly allocated by chance, and both groups were exposed to 10 puffs of an electronic cigarette. Researchers then measured levels of different cells that play key roles in the regeneration of the lining of blood vessels, called endothelial progenitor cells (EPCs), and can lead to atherosclerosis — that is, the build-up of fatty plaques.

"It was demonstrated that such exposure to electronic cigarette smoke did indeed increase the levels of EPCs measured at one hour. (At 24 hours they had fallen back to normal levels.)

"However, it is not clear why. Is this simply due to nicotine, and therefore would also be found with other harm reduction strategies such as nicotine patches or gum? Or is it due to other constituents in the vapour? Is this more or less than found with traditional cigarettes?

"Such findings would also need replicating in groups several magnitudes of order greater before we can apply these results to the real world. And they may still be due to chance. Indeed, tobacco and e-cigarette smoke, both active and passive, would need to be compared to see which causes more harm. But obtaining ethical approval for such a study would be challenging.

"Finally, the possible harms of cigarette smoking — atherosclerosis, high blood pressure, heart attacks, stroke and death — accrue over months to years, not minutes to hours. This is something this research cannot address.

"Based on this study, e-cigarettes still represent the lesser of two evils when compared to the evidence of overwhelming harm from tobacco smoke. But more research is needed on the long-term harms of e-cigarettes, both to the cardiovascular and respiratory systems. Furthermore, it remains difficult to say if e-cigarettes or other forms of nicotine replacement are safer than another."

Perhaps 'Ask For Evidence' could offer its readers a more nuanced and accurate assessment of the relative health implications of vaping to smoking?

Update 2016-12-07