Smokers increasingly overestimate vaping risk - study

E-cigarettes carry a fraction of the risk of cigarettes, the NHS says

Fewer smokers in England now see vaping as less harmful than cigarettes, despite evidence tobacco is far worse for health and e-cigarettes can help smokers quit, data suggests.

Perceptions are shifting, according to survey responses from more than 28,000 current smokers between 2014 and 2023.

The latest round of results found 57% thought vaping just as harmful as smoking or more so.

Ideally, people should neither vape nor smoke, the NHS says.

• NHS: Is vaping harmful?

Vaping exposes users to far fewer toxins and at lower levels than smoking cigarettes.

Cigarettes release thousands of different chemicals when they burn.

Many are poisonous and up to 70 cause cancer.

They also cause other serious illnesses, including lung disease, heart disease and stroke.

Most of the harmful chemicals in tobacco smoke, including tar and carbon monoxide, are not in vape aerosol.

But vaping is not risk-free. And the NHS advises non-smokers and young people under the age of 18 not to start.

Common side effects of vaping include:

• coughing, dry mouth and throat

• mouth and throat irritation

• shortness of breath

• headaches

The data, published in the journal JAMA Network Open comes from a Cancer Research UK-funded weekly survey running since 2006 to track national smoking patterns and inform stop-smoking policies.

In November 2014:

• 44% of smokers thought vaping less harmful than smoking

• 11% more so

• 30% equally harmful

• 15% did not know

But by June 2023:

• only 27% thought vaping less harmful

• 23% more so

• 34% equally harmful

• 16% did not know

It's not clear what is behind the trends - the study didn't look at that. But stop smoking experts are concerned.

One of the researchers, Dr Sarah Jackson, from University College London (UCL), said: "These findings have important implications for public health.

"The risks of vaping are much lower than the risks of smoking - and this isn't being clearly communicated to people.

"This misperception is a health risk in and of itself, as it may discourage smokers from substantially reducing their harm by switching to e-cigarettes.

"It may also encourage some young people who use e-cigarettes to take up smoking for the first time, if they believe the harms are comparable.

"Better communication about the health risks is needed so that adults who smoke can make informed choices about the nicotine products they use."

• How dangerous is vaping?

• Vape safety message luring in children, says expert

• How do you quit vaping?

Prof Jamie Brown, also from UCL, said: "E-cigarettes are novel and so have attracted much attention in the media, with news articles often overstating their risks to health compared with smoking.

"There is relatively little reporting about deaths caused by smoking, even though 75,000 people die as a result of it in England each year.

"The government plans to offer one million smokers a free vaping starter kit alongside behavioural support to help them quit.

"This initiative may be undermined if many smokers are unwilling to try e-cigarettes because they wrongly believe them to be just as harmful as cigarettes or more so."

Simon Clark, director of the smokers' group Forest, agreed that there had to be better communication about the relative risk of different nicotine products, including combustible tobacco and e-cigarettes, but added: "Government is partly to blame for the confusion because banning disposable vapes and threatening to severely restrict the display and packaging of e-cigarettes is hardly the best way to promote a reduced risk product that has helped millions of smokers to quit.

"Furthermore, is it any wonder that smokers are confused about the perceived risk of vaping when the message coming from government and the public health industry is that the only people who should vape are adults who want to quit smoking, and no-one should vape long-term or recreationally."

Action on Smoking and Health (Ash) chief executive Deborah Arnott said "scare stories" about young people vaping could be causing the growing misconception among adult smokers that vaping was at least as risky as smoking.

"There are millions of smokers who may, as a result, never try the most effective and easily available quitting aid, the e-cigarette," she said.

"The tragedy is that as a result many smokers may carry on smoking when they could have quit, continuing to put themselves at serious risk of cancers, respiratory and heart disease, followed by premature death."