Research focus

Research focus: E-cigarettes

In recent years e-cigarette use has increased significantly and may be seen as a safer smoking alternative or a method of smoking cessation. Three recent research articles on e-cigarettes are summarised.

In recent years e-cigarette use has increased significantly and may be seen as a safer smoking alternative or a method of smoking cessation. Three recent research articles on e-cigarettes are summarised.

More research is needed into the potential harm from e-cigarettes. Picture: iStock

Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group

When patients are diagnosed with lung cancer, they are advised to stop smoking to improve outcomes. E-cigarettes may be seen as an alternative method of smoking cessation. In this study, the authors surveyed British thoracic oncology group (BTOG) members to explore their perceptions of patients’ e-cigarette use, knowledge of current guidance, and advice given to patients with lung cancer.

An online survey link was added to three e-newsletters sent to BTOG members. Of 2009 members, 154 (7.7%) completed the survey. Of those with direct patient contact, 81.3% were asked about e-cigarettes in the previous year, but almost three quarters (72.4%) were not aware of the International Association for the Study of Lung Cancer statement recommending e-cigarettes for lung cancer patients be discouraged due to lack of safety evidence. Most respondents (92.6%) felt they needed more information and guidance to feel confident advising patients. Confidence giving advice varied between respiratory specialists (35.7%) and nurses (17.9%), and between men (60.7%) and women (39.3%).

Although the small sample might not be a true representation of BTOG members, the authors highlighted the need for continued research into potential harm from e-cigarettes and provision of standardised training for healthcare professionals around patient advice.

Sherratt FC, Newson L, Field JK (2016) Respiratory Research 17(55) doi:10.1186/s12931-016-0367-y


E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers’ views

This qualitative study aimed to explore UK teenagers’ perceptions and use of e-cigarettes. They used purposive sampling to identify eighty-three 14-17 year olds from Scotland and the North of England and ran 16 focus groups.

Four main themes arose. Perceptions of harm were varied, with some participants likening e-cigarettes to how tobacco used to be marketed and highlighting the lack of knowledge about long-term harmful consequences, but most felt that vaping was less harmful than smoking.

E-cigarettes were seen as attractive to children and teenagers as they were ‘fun’ and ‘colourful’ and a safer way of rebelling than smoking, as well as a less harmful way of trying smoking. Participants also described examples of teenagers using e-cigarettes instead of cigarettes to ‘fit in’ and ‘look cool’. The third theme explored perceptions of e-cigarette experimentation and use with cigarettes, drawing on discussions from the previous theme.

Although the groups agreed that e-cigarettes mostly benefited older smokers trying to quit, nine groups saw e-cigarettes as fun products for parties – conversation starters and getting a ‘nicotine buzz’ – with two more groups saying that e-cigarettes could support and hide a smoking habit when cigarettes could not be used. The final theme looked at online environments, with six groups discussing the viral spread of ‘tricks’ involving vaping on social media sites such as Facebook and YouTube.

The authors concluded that the covert use available to users of e-cigarettes might reinforce smoking habits in teenagers and further research needs to be done. They believe future guidance on e-cigarettes needs to meet the needs of young people as well as established older smokers.

Hilton S, Weishaar H, Sweeting H, et al. (2016) BMJ Open 2016(6) e013271. doi:10.1136/bmjopen-2016-013271


E-cigarettes for immediate smoking substitution in women diagnosed with cervical dysplasia and associated disorders

Smoking is a known risk factor for cervical cancer. This American study aimed to examine the impact of nicotine replacement therapy and e-cigarettes on smoking cessation or reduction in women diagnosed with, or at risk of, cervical dysplasia. 

A convenience sample was used of 29 female smokers diagnosed with cervical dysplasia or cancer, or Human Papilloma Virus, who chose e-cigarettes for the 6-week smoking reduction study. Twenty-six participants were assessed at 6 and 12 weeks for median cigarette reduction or abstinence, and e-cigarette use.

At six weeks, average reported cigarettes per day (cpd) dropped from 18.5 to 6, and 4 women (14.3%) were abstinent. At 12 weeks, cpd dropped to 5.5, and 8 were abstinent with 4 not using e-cigarettes either. Average e-cigarette use decreased from 21 cartridges to 12.5 for each six-week period.

The authors concluded that e-cigarettes are an acceptable substitute for cigarettes, but that further research is needed to identify the most successful smoking cessation methods for high-risk populations.

James SA, Meier EM, Wagener TL, et al. (2016) International Journal of Environmental Research and Public Health 13(288) doi:10.3390/ijerph13030288


Compiled by Kat Millward, lecturer at City, University of London

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