Non-smokers who vape ‘at risk’ to start regular smoking: research

30 September

Rachel Clun, The Sydney Morning Herold:

People who had never smoked but who use e-cigarettes are three times more likely to start regular smoking.

Research commissioned by the Federal Department of Health has examined evidence from previous studies as well as national data to get a snapshot of smoking and e-cigarette behaviour.

The research found using e-cigarettes – or vaping – increases the chance of non-smokers switching to cigarettes, while evidence e-cigarettes could help people quit smoking remains unclear.

Australian National University epidemiologist and public health expert Professor Emily Banks said one of the major findings was non-smokers who used e-cigarettes were three times as likely to take up regular smoking.

“It stands to reason that if you become addicted to nicotine, and you are in the habit of inhaling nicotine, that would be likely to put you at risk of taking up smoking,” she said.

The report, published on Wednesday, is a summary of preliminary findings made by the researchers who were reviewing the health impacts of e-cigarettes. The findings have been pre-printed and were either undergoing peer-review or will be peer reviewed in the future.

Professor Banks said they found there was very limited research on the potential benefits of e-cigarettes as a quit smoking aid.

“The early evidence looks promising … we just have a lack of evidence, the jury is out,” she said.

Professor Nicholas Zwar, who was chairman of the expert advisory group behind the Royal Australian College of General Practitioners guide on supporting smokers to stop, said a review of literature they commissioned came to slightly different conclusions about e-cigarettes.

“I think there’s the increasing evidence that they can help people to quit, and that they may be somewhat more effective than standard nicotine replacement, but the quality of the evidence is low,” Professor Zwar said.

“We certainly need more and better quality trials.”

In the guide to GPs published earlier this year, e-cigarettes were cautiously suggested as a second-line aid for people who wanted to quit smoking, and Professor Zwar said that advice still stood.

“Being able to offer nicotine containing e-cigarettes seem to us to be a reasonable thing to consider,” Professor Zwar said, adding while there was no long-term evidence they were also likely to be less harmful than combustible cigarettes.

Dr Alex Wodak, director of the Australian Tobacco Harm Reduction Association and president of the Australian Drug Law Reform Foundation said it was hard to comment on a summary report.

However, he believed his view that the therapeutic benefits outweigh the harms would eventually become mainstream.

“Australia is unique among Western democracies to be so hostile to vaping and other forms of tobacco harm reduction,” he said.

Professor Banks said it was important the public was offered evidence-based treatments.


“If we do want to see it available to smokers, for smoking cessation, then we have to have the evidence that they’re safe, and they’re effective,” she said.

As 97 per cent of people aged 14 to 17 have never smoked, Professor Banks said it was vital to protect young people from developing the habit.


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