February 18th, 2016

Smoking and vaping in Britain? Show me the data!

E-cigarettes versus cigarettes – show me the data

The UK official statistics bureau, the Office of National Statistics, has published new official smoking and vaping stats for 2014, with the bonus of an e-cigarette survey for 2015. The geographical base is Great Britain (GB) – the difference between Great Britain and the United Kingdom is Northern Ireland. The age range is ≥16. Pretty good news…

Source materials from ONS

Some highlights

I’ve looked into it so you don’t have to….  here are some statistical nuggets from the 2015 data on e-cigarettes.

  • There are 8.8m smokers in Britain
  • 2.20 million people are using e-cigarettes – almost all are smokers (1.30m or 59%) or ex-smokers (849k – 39%) – with a few never-smokers (56k – 2.5%).
  • A grand total of 8.7m Brits have used or tried e-cigs: 2.2m current users; 3.9m former users; 2.6m tried but did not go on to use e-cigs
  • 64% of current smokers have tried an e-cigarette and 15% are currently e-cig users – to me this represents future public health potential
  • Only 0.2% of never-smokers are current e-cigarette users – these are the same people as the 2.5% of e-cig users who never smoked. Even so – and funnily enough – 39% of these never-smokers said they used e-cigarettes as an aid to quit smoking (a reminder that this may not be an exact science!)
  • Female e-cigarette current use is slightly higher (4.5%) than male (4.2%)
  • Peak prevalence in men is age 55-64 (5.8%) but younger in women 35-44 (6.7%)
  • Two main reasons are given for using e-cigarettes: perceived as safer than smoking (22%) and as an aid to stop smoking (53%) – note that these could both be true for many users. Only 9% say they use e-cigarettes because they can be used indoors
  • Two-thirds (67%) of e-cigarette users are daily users
  • Only 23% of e-cigarette users use cig-a-likes (devices that look like cigarettes)
  • Risk perceptions – interestingly ONS subdivided perceptions into ‘much less‘ and ‘somewhat less‘ harmful – which is good, because magnitude matters.  These are the perception figures for all current and ex-smokers who have not used e-cigarettes:
    • 29% – Much less harmful than cigarettes
    • 39% – Somewhat less harmful than cigarettes
    • 24% – About as harmful as cigarettes
  • These are the risk perception figures for current and former e-cigarette users – neatly illustrating how experience changes perception:
    • 43% – Much less harmful than cigarettes
    • 33% – Somewhat less harmful than cigarettes
    • 18% – About as harmful as cigarettes
  • 59% all persons ≥16 believe that e-cigarettes have no health impact on non-users, 37% believe a damaging impact.
  • Many other figures and breakdowns in the data sources listed above.

This is all mostly pretty good news. In particular, 850k ex-smokers are currently using e-cigs and a further 720k ex-smokers used e-cigs in the past but no longer. This is a substantial proportion of the smoking population over the period in which e-cigs have been rising.  Note that we cannot say they are ex-smokers because they used e-cigarettes. The important thing is that they are ex-smokers. It may also be that e-cig use is valuable in preventing relapse.

What’s the bad news? I think the main reason for concern is the persistent misperception of vaping risk – most people think it is much more dangerous than is plausible based on what we know of the chemistry and physics of e-liquid vapour and cigarette smoke.  Less than one-third of those in the most at-risk category (smokers / ex-smokers who have not tried e-cigs) have a realistic perception of the risk of  e-cigarettes (i.e. ‘much less harmful’ than cigarettes) and even among users less than half have realistic perceptions (and are likely to be more at risk of relapse as a result – if you are struggling to make vaping work, why would you bother if you don’t think the risk is that much lower?

I guess we can thank the wildly irresponsible statements from public health academic and commentators and extensive slovenly journalism for this unhappy state of affairs – and the resultant protection of the cigarette trade from the competitive threat of superior new consumer technology.

What’s going on with smoking?

Here’s the trend, just plotted from the data released…

GB smoking prevalence

Note, the 2015 e-cigarette survey shows smoking prevalence continuing to fall – to 17.5%. This is from a different dataset to the one plotted above, so I haven’t added it to this chart. But this is how it would look.

GB smoking prevalence - 2015

Commentary

Watch Hazel Cheeseman of ASH (London) and Professor Peter Hajek of Queen Mary College discuss the results and the issues raised in the debate – this is very good.

Note to American, Canadian, Australian and WHO tobacco control activists: this is what honest discussion of e-cigarettes sounds like.

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