A reflection of the history and the possible future of vaping.
The Global State of Tobacco Harm Reduction (GSTHR) release a report every two years. GSTHR map the sale and regulation of safer nicotine products across the world. This year’s article is titled ‘The Right Side of History’ and reflects on the history of tobacco harm reduction.
This blog is going to provide a brief summary of the report and talk about the points raised by the article.
“The global public health crisis caused by smoking sees eight million deaths each year, more than from HIV/AIDS, tuberculosis and malaria combined.” (GSTHR, 2022) .
We all know that smoking is bad for your health, but the true scope of the issue is never really touched upon. With just under 75,000 smoking related deaths each year in England alone, more needs to be done. Smoking harms practically every organ in your body and there is no safe way that someone can be exposed to tobacco smoke .
Until the creation of nicotine replacement therapies (NRTs), people had no options other than continuing to smoke or quitting cold turkey. With the creation of NRTs, a smoker now has a number of safer options to support their quit attempt .
GSTHR estimates show that over 112 million people already use NRTs worldwide. Around 4.3 million of those are vapers in England alone [4, 5].
While smoking has existed for thousands of years, it was only in the 1950s when the dangers of smoking were truly realised, and it wasn’t until the 1970s that scientists realised that nicotine was responsible for tobacco being so addictive.
A Swedish invention called ‘snus’ was one of the first forms of NRT. Snus is a nicotine pouch that is placed under the lips or tongue. The popularity of snus showed the first real population scale health benefits of using NRTs.
In 2003, a pharmacist in China named Hon Lik developed a way of vaporising nicotine solution that could mimic smoking, but in a much safer form. In 2004 the company that Hon Lik worked for began selling their devices. And thus, vaping was born.
It was during these early years that vapers started to share their success with communities, both online and in person.
As vaping became more popular, governing bodies began to notice the surge of new vapers and set to work on creating regulation to protect vapers from harmful products.
One of these key pieces of regulation was the first draft of the EU Tobacco Products Directive (TPD) in 2013. The TPD is still being used today to help keep vapers safe and became the Tobacco and Related Products Regulations 2016 in the UK.
It didn’t take long for health organisations to start to see the relative benefits of vaping. The NHS, Office for Health Improvement and Disparities (OHID) and Cancer Research UK all concluded that vaping was around 95% less harmful than smoking, and began to promote it as a safer alternative.
But, it wasn’t all smooth sailing. Before long the big tobacco companies and organisations that they influence began to interfere .
Misinformation about vaping has been huge over the years. With myths about vaping related illness and death still being discussed today. ‘Popcorn lung’ is still a worrying subject amongst smokers and new vapers, even though scientific evidence has disproven it.
Many governments across the world have made vaping illegal, whilst tobacco products are still readily available. The USA is a key example of this when they caused a media storm in 2020. E-cigarette or vaping associated lung injury (EVALI) was the name given to the damage caused by vaping illicit substances that were harmful and even fatal. Of course, vaping was blamed for these deaths and not the actual liquid that they were vaping.
Luckily, the UK is one of the most progressive countries in the world around vaping, and specifically the role that it can play is supporting smokers quit. In fact, vaping is planned to play a major role in the government’s ‘smokefree 2030’ plans.
In order for vaping to continue to maintain the success in helping many more billions of smokers quit, a lot needs to change. Like the UK, many global governments need to recognise the relative safety of vaping alongside other NRT , rather than stigmatising or demonising it.
In addition, the media must ensure that they represent a balanced perspective around vaping alongside other NRT options, and equally highlight the many positives and proven benefit that it can play in supporting global smoking cessation.
Scaremongering, and sensationalising isolated stories, whilst important to investigate alongside a balanced view, can only exacerbate the current inaccurate view of the majority. Only 42% of UK adults believe vaping to be less harmful than smoking, and only 12% of adults correctly stating that e-cigarette use is a lot less harmful than smoking.
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 Global State of Tobacco Harm Reduction. (2022). The Global State of Tobacco Harm Reduction 2022: The Right Side of History. [Online]. GSTHR. Last Updated: 15 November 2022. Available at: https://gsthr.org/briefing-papers/the-global-state-of-tobacco-harm-reduction-2022-the-right-side-of-history/ [Accessed 22 November 2022].
 Action on Smoking Health. (2021). Smoking Statistics. [Online]. Action on Smoking Health. Last Updated: May 2021. Available at: https://ash.org.uk/resources/view/smoking-statistics [Accessed 22 November 2022].
 Shapiro, H. (2020). Burning Issues: Global State of Tobacco Harm Reduction 2020. Knowledge-Action-Change. https://gsthr.org/resources/item/burning-issues-global-state-tobacco-harm-reduction-2020, Chapter 4.
 Office for Health Improvement & Disparities. (2022). Nicotine vaping in England: 2022 evidence update main findings. [Online]. gov.uk. Last Updated: 29 September 2022. Available at: https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-main-findings. [Accessed 22 November 2022].
 Action on Smoking & Health (2022). Use of e-cigarettes (vapes) among adults in Great Britain 2022. [Online]. Action on Smoking Health. Available at: https://ash.org.uk/resources/view/use-of-e-cigarettes-among-adults-in-great-britain-2021. [Accessed 22 November 2022].