Electronic cigarettes have become a common product in modern-day culture, so much that it’s almost more common to see people puffing on them than on conventional cigarettes. But is that really a good thing?

Public Health England (PHE) seems to think so. According to the UK agency, smoking e-cigarettes, or vaping, is 95% less harmful that smoking tobacco, and the devices could one day be prescribed as a licensed medicine as an alternative to antismoking products.

The health body said that although e-cigarettes are not free from risk, it now believes that they “have the potential to make a significant contribution to the endgame for tobacco.” PHE also claimed that there is no evidence that the devices are a gateway into smoking tobacco for children or nonsmokers.

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The message, which was based on a 119-page review, was backed by England’s chief medical officer, Dame Sally Davies. “I want to see these products coming to the market as licensed medicines,” Davies said. “This would provide assurance on the safety, quality, and efficacy to consumers who want to use these products as quitting aids, especially in relation to the flavorings used, which is where we know least about any inhalation risks.”

Not everyone, however, is convinced by PHE’s dramatic numbers. A week after the medical body released the report, the British medical journal The Lancet published an article refuting PHE’s claims. It questioned the sources PHE used to come to the 95% statistic. One was a briefing report to the UK All-Party Parliamentary Group on Pharmacy. The other was a paper by former UK government chief drug adviser David Nutt and colleagues published in European Addiction Research. The paper describes how the Independent Scientific Committee on Drugs, which was founded by Nutt in 2010, brought together an international expert panel to consider the “relative importance of different types of harm related to the use of nicotine-containing products.” The panel assessed different products and based on the opinions of the group, cigarettes were ranked as the most harmful nicotine product with a score of 99.6. E-cigarettes scored only 4% of the maximum relative harm. Thus, this is how PHE arrived at the “95% less harmful figure.”

Several of the paper’s authors were also found to have had ties to e-cigarette companies, which was noted as a conflict of interest in the paper but not in PHE’s report.

“Tobacco is the largest single cause of preventable deaths in England—e-cigarettes may have a part to play to curb tobacco use,” says the Lancet editorial. “But the reliance by PHE on work that the authors themselves accept is methodologically weak, and which is made all the more perilous by the declared conflicts of interest surrounding its funding, raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency’s peer review process.”

Despite the backlash, PHE said it stood by its original report.

So what’s the takeaway? The answer is that there is simply still a lack of long-term data to make a definitive conclusion. Electronic cigarettes were, after all, only invented in 2003.  The general consensus is that e-cigarettes are less harmful than conventional cigarettes because there is no smoke or burning involved, and the number of chemicals being inhaled is 4 to 5 as opposed to 4000. The question is: how will those 4 or 5 chemicals affect the body?

More information on electronic cigarettes from The Medical Bag:

They’re the Cigarette of the 21st Century, but Are They Good for You? (https://www.themedicalbag.com/vitalsign/theyre-the-cigarette-of-the-21st-century-but-are-they-good-for-you)

Electronic Cigarette Update: Report Says E-Cigs Less Harmful Than Tobacco (https://www.themedicalbag.com/vitalsign/electronic-cigarette-update-report-says-e-cigs-less-harmful-than-tobacco)


  1. E-cigarettes: Public Health England’s evidence-based confusion. Lancet. 2015;386:829. doi: http://dx.doi.org/10.1016/S0140-6736(15)00042-2.
  2. Hearon L. Not so fast vapers: Bristish medical journal blasts e-cigarette safety study. http://mashable.com/2015/08/28/vaping-study-blasted. Published August 28, 2015. Accessed September 2, 2015.
  3. Meikle J. Vaping: e-cigarettes safer than smoking, say Public Health England. The Guardian website. http://www.theguardian.com/society/2015/aug/19/public-health-england-e-cigarettes-safer-than-smoking?CMP=share_btn_tw. Published August 19, 2015. Accessed September 2, 2015.
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