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An estimated 2.6 million people now use e-cigarettes in the UK. And this rapid rise in popularity – along with the huge range of products on sale – has meant that research on the devices has struggled to keep up.
It’s no surprise then that e-cigarettes have become a bit of a contentious public health issue, with vapers, scientists and the media all debating the potential positive or negative consequences of their use.
As we’ve previously said, e-cigarettes are almost certainly far safer than tobacco cigarettes.
But the only way to settle this debate – and to realise their potential – is through research.
Long-term, high-quality studies are crucial to provide reliable evidence about these products’ effects on our behaviour, physiology and health, and allow us to continue to provide evidence-based recommendations to policy makers.
And since policy makers in the UK are already facing legislative decisions around e-cigarettes, the planning about what research to do has to happen now.
With so much to gain if e-cigarettes are proven to help people ditch tobacco, we’re making research on e-cigarettes a key priority.
So let’s take a look at the research we’re already funding, and how we’re working with the research community to identify new questions to answer.
What we’re already funding
It’s important to point out that we already fund research on e-cigarettes. In fact, we’ve recently increased our budget for e-cigarette research, with an additional £5 million via both our Tobacco Advisory Group, and our Population Research Committee.
This means we’ve been able to fund an extra 12 research projects. This includes exciting new research on how young adults understand and experience the devices; their impact in people with mental illness; and a long-term study looking at ‘real-world’ examples of how e-cigarettes may help people quit smoking.
These projects will help answer some of the burning questions on e-cigarettes.
But what else do we need to know?
To find out, we held two workshops earlier this year in collaboration with the British Lung Foundation (BLF), British Heart Foundation (BHF), the Department of Health, the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the Wellcome Trust..
What should we be funding?
The workshops were themed around research that would look at how e-cigarettes work, and what happens when people use the devices. And we brought together scientists, health professionals, policy-makers and representatives from the vaping community to discuss the key research questions.
The workshops were aimed at understanding what we already know, and identifying the key research gaps in this area. And a number of key priority areas for future research were raised for further consideration:
- Drivers: What are the external factors that affect people’s behaviour and perceptions of e-cigarettes (e.g., marketing, regulation, public health messaging etc.)?
- Perceptions: What are the psychological factors (e.g., attitudes, beliefs, etc.) that influence how people use e-cigarettes (e.g., intermittent, regular, dual, non-use)?
- Behaviours: What are the patterns of e-cigarette and tobacco cigarette use in the UK? And, crucially, how effective are e-cigarettes for quitting smoking?
- Mechanisms: What are the biological effects of nicotine and constituents of vapour in e-cigarettes? How does this vary between vapers and devices (e.g. puff duration, voltage, particle size and density etc)?
- Outcomes: What are the longer-term health effects from using e-cigarettes? (e.g., in pregnancy, quit rates, relapse rates etc. and can we use early biomarkers or existing cohort studies). And what are the potential consequences for vulnerable populations? (e.g., pregnant, adolescents, mental health, etc.)
We’ll also be working with the workshop partners and other funders, including the British Lung Foundation (BLF) and the Wellcome Trust, to promote our existing funding streams to e-cigarette researchers.
As well as the workshop, we’ve also been working with Public Health England on the new UK Electronic Cigarette Research Forum (UKECRF), which has established a network of researchers, policy makers and practitioners to discuss research relating to electronic cigarettes and how this relates to policy.
The UKECRF is chaired by Professor Ann McNeill from the UK Centre for Tobacco and Alcohol Studies. And we’ve been working with the University of Stirling to provide a series of monthly updates to this network on new research as it emerges.
Another way we’ve been working with other funding organisations to create additional resources that may help e-cigarette research, is with the Cohort Directory – a list of ongoing large UK population studies that could provide useful data to researchers studying e-cigarettes.
Created by the MRC, in collaboration with us, BHF, ESRC, and the Wellcome Trust, the directory helps researchers and policymakers find and use them more easily.
It’s absolutely vital that people are made aware of any potential tobacco industry involvement with e-cigarettes
To fully capitalise on e-cigarettes’ potential, while minimising any risks, we clearly need a better understanding of their impact.
But it’s only by taking the time to do high-quality research that we’ll confident we can minimise any risks associated with e-cigarettes – while capitalising on their potential benefits.
This is a fast-moving market, with products evolving alongside public perceptions, marketing and regulation, both in the UK, and at an EU level with the Tobacco Products Directive coming into force in 2016.
And it’s absolutely vital that people are made aware of any potential tobacco industry involvement with e-cigarettes. With Big Tobacco’s big role in marketing deadly tobacco products for many years, we must make sure they aren’t given the opportunity to engage in public health discussions around e-cigarettes too.
– Lucy Davies is a research funding manager at Cancer Research UK
- If you are interested in being involved in future activities relating to e-cigarette research please contact our Involvement Team at [email protected]
Ray Williams November 26, 2015
E-Cig are the invented to quit smoking. But at the same time nothing should be habituated. E-cig are not harmful if they are taken from a guaranteed store. Quit smoking and live a healthy life.
Adam N August 13, 2015
“And it’s absolutely vital that people are made aware of any potential tobacco industry involvement with e-cigarettes.” It’s also absolutely vital that you make it known loud and clear that the tobacco industry is still a minor player in this market.
Before the TPD we warned you in your blogs of the dangers of med regs but you wouldn’t listen, now we are facing a disaster with the TPD banning all the devices that work. Do you realise what will happen yet, we will be left with one industry controlling the market and that industry will be your friends from Phillip Morris. Useless and inferior cigalikes will be the only things on the market, any high quality devices will be banned and that is a fact. You need to listen to us now, the date of guilty knowledge has passed.
It’s all well and good being supportive now but where were you in 2012? The damage has been done unless Totally Wicked can win at the European Court. No one listened to us then and it seems the same thing is happening now, we are facing the destruction of an industry here that will then be handed on a plate to the tobacco industry, are you comfortable with that?
The EU did what big pharma asked it to do, yes med regs were defeated but in its place and decided behind closed doors we got med regs light. No tanks over 2ml in volume, no leaking, no tampering, consistent dose, 20 mg/ml threshold, a six month notification, emission tests etc etc. No 2nd/3rd/4th generation device can survive these regulations but we know what can and so do the tobacco industry!
So you can do all your tests, good luck to you, but it won’t matter because the deed is done and that’s thanks to your lack of support when it mattered. Tony Holden has got it spot on below, you should read that post over and over and then hopefully you’ll understand how wrong you were before and how clueless you are to the impending disaster of the TPD.
Norbert Zillatron August 13, 2015
I agree, there is need for solid scientific research on vaping.
Especially to rectify all the damage that has been done by the plethora of junk science (accidental, but mostly intentional) that keeps drenching the media and influencing policy makers.
I’m writing about “Vaping and Science” from a long term vapers perpective in my blog [ https://nzillatron.wordpress.com/ ]. Please have a look and consider my points. To avoid falling into the common trap of professional tunnel vision. There I elaborate on the topics I mention here and some more.
E.g. from a medical point of view, the question “How effective are ecigs vs NRTs and how can we increase the efficacy” may seem obviously an important one. But also it most often implies the need for a rigid framework to test it with RCTs. And these RCTs then have rather poor results in direct contrast to the rapidly growing number of ex smokers turned vapers. What happended? Dismissing and eliminating factors like arbitrary flavours and a large variety of devices, inluding the free choice of nicotine content or even when and how to use it, researchers inadverted removed all those attributes that distinguish a successful, enjoyable consumer product from pretty useless NRTs. Imposing rigid medicinal style regulation on vaping–even with the best intentions–will do just the same: Render it useless. And the TPD already is giant faux pas in this direction.
You can also gain a lot of information for planning your research from the internet surveys done by forums, vapers, shops, and other scientists. Some so-called “experts” dismiss them as useless because of the self selection bias.
Useless? Only if you are blind to what they really tell: The common traits of the most successful, active vapers. People that fear to have their choice taken away by “regulation”. To be forced to return to vastly inferior, vastly more harmful products. People like me. People who also think about the billions of current smokers who’ll never even will have the opportunity to try a superior alternative that will be “regulated” out of existence.
Avoid seemingly sensible assumptions. Ask experienced vapers. That’s what the authors of the “Freaking Formaldehyde” study should have done that kicked off a series of followup junk science.
They simply assumed that vapers will increase the power level on an adjustible device to get more nicotine. That this would be the prime reason to have adjustable voltage. This misconception lead to the false conclusion that it might be quite common to have huge amounts (but still far less than in every cigarette) of formaldehyde in the vapour.
It’s like assuming that it would be quite common to use a toaster at the highest setting, just to get the toast extra crisp. Completely ignoring the fact that the resulting piece of carcinogenic charcoal is not very palatable.
So, please do some solid research. From all of Europe, the UK offers the best chances to do real science. And have it count politically. Help the rest of Europe. We seem to be heading into an other age of ignorance where ideology, superstition and greedy lobbies dominate over sciencentific values.
Tony Holden August 13, 2015
Throughout this post I see no mention of you engaging with the actual experts in this field, the people who use ecigs.
We could tell you that the TPD will ban all but the least effective e-cigarettes, and those are, in the main, produced by those big tobacco companies you distrust so much.
We could tell you about the research already conducted on the liquids, about the ingredients we don’t want to see in them, and how flavours can help.
We could tell you about the relationship between coil resistance, voltage and wattage, together with wicking material and nicotine levels, and how they can change the characteristics of the experience.
We could tell you about all the work of researchers like Dr. Farsalinos, and how he has debunked badly designed, and badly interpreted research.
But you’ve been navel gazing in workshops with other groups who are equally clueless.
Instead you’re going to try to reinvent the wheel at five minutes to midnight. By the time you reach all the conclusions we’ve been talking about for months, if not years, the TPD will be in force, tobacco and pharmaceutical companies will be happy, and we will have lost the best opportunity to eradicate smoking for at least another generation.
Geoffrey Scrace August 12, 2015
Maybe you should be conducting research into what driving force is behind the EU drawing up legislation which will effectively ban proven tobacco cessation devices.
Liam Bryan August 12, 2015
I wonder if CRUK have done any work into the effects of the TPD on ecigs’ ability to stop people smoking? I think it will be disastrous.
Rob Crewe August 12, 2015
Patrick McGuire – They are normalising NOT smoking. Restricting the sale as medical products while conventional tobacco remains freely available is nonsensical.
Patrick McGuire August 12, 2015
Another issue that concerns me is that of the danger of e-cigarettes “normalising” smoking once again. If they are of use as an aid to help smokers quit smoking then it would be more appropriate if they were regulated as a “health” product in the same way as other such products.
Dodderer August 12, 2015
It is interesting what the situation would now be if there was no Tobacco Control industry and researchers.Ecigs would have been allowed to develop naturally – the consumer deciding what works and what doesn’t.
We have known for decades that nicotine doesn’t kill you and that PG/VG are benign substances – the biggest threat that ecigs pose is really to the legions of TC people who are dependent on the status quo i.e. non-measurable improvements in prevalence from all their policy initiatives and cessation products.
There are now 1.1m GB ecigs quitters yet this seems to be irrelevant as TC worthies earnestly discuss ecig quitting potential.It’s here,it’s now and it’s passed you by because you’re more interested in policy and strategy than in real people actually stopping.The impact of ecigs on Tobacco Control is irrelevant – what matters is the impact on smokers and they’re quitting in droves.
Rob Crewe August 12, 2015
Doug Taylor – Perhaps there may be a possible potential for e-cigs to be used as a gateway to tobacco use, but only of homeopathic proportions.
Rob Crewe August 12, 2015
Sadly, any further research into electronic cigarettes and vaping is moot. From May 2016 all effective vaping devices will be banned under Article 20 of the EU TPD, defining them as tobacco products and handing the entire industry to the tobacco companies.
Dee August 12, 2015
Do what you like. You had your chance before the TPD was signed and sealed to stand up for Ecigs. You and other orgs like you are will be the cause of people not being able to purchase ecigs in 2016.
You failed to listen for years and now you want to talk ?
Good luck with your future, we’ve had to purchase ours.
Mark magenis August 12, 2015
Doug, the 0.14 use figure from surveys suggests this is an unlikely problem, or as stated in BMJ “the gateway theory is utter bullshit” – D Arnott
Doug Taylor August 12, 2015
Is there any reason you are not also researching the possible potential for e-cigs to be used as a gateway to tobacco use? This would seem to me to be a particular concern for youngsters who may be attracted to e-cigs.
Mark Magenis August 11, 2015
Unless you can identify a cancer risk from ecigs, are you not acting outside your remit in regards to discussions of control of these products?