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E-Cigarettes Could the Save the Lives of Millions of Smokers. Why Aren’t We Talking About It?

The opinions expressed by columnists are their own and do not necessarily represent the views of
AP Photo/Steven Senne, File

E-cigarettes have been getting a lot of bad press lately. The leading manufacturer in the US, Juul, is under investigation for marketing to minors. Now the House Oversight and Government Reform Subcommittee has scheduled a hearing for July 24. 


Separately, the Surgeon General has issued dire warnings about an “epidemic” of teen vaping. Regulators and local policymakers are cracking down on the industry. Public health advocates have (wrongly) condemned e-cigarettes as unsafe, lumping them in with combustible tobacco products.

But there’s another side to the story that isn’t attracting enough attention: Mounting evidence suggests that e-cigarettes are remarkably effective at getting smokers to quit. In a country of 34.3 million smokers, where 1,300 people succumb to smoking-related illnesses every day, one would think that policymakers would be eager to popularize a product that could save the lives of millions. 

Public Health England, a highly-respected institution in the U.K., has concluded that e-cigarettes are at least 95 percent less harmful than conventional cigarettes, and other health organizations, including the Royal College of Physicians, National Academies of Science, Engineering, and Medicine, and American Cancer Society, have acknowledged that vaping is far safer than smoking.

Of course, no nicotine produce is completely safe, and there are reports that vaping carries health risks and has been linked to diabetes, elevated heart rate, and respiratory disorders. To be sure, no one thinks teens should have access to e-cigarettes, and non-smoking adults would be well advised to steer clear as well.


But smokers are turning to e-cigarettes in record numbers seeking a safer source of nicotine. A peer-reviewed study in 2016 found that one-third of U.S. smokers used e-cigarettes in their last quit attempt, and that vaping has contributed to a 50% increase in the rate of smokers using cessation aids.

In a recent randomized trial, the gold standard in scientific research, British researchers recruited about 900 people who wanted to quit smoking and randomly assigned half to use e-cigarettes and the other half to use other nicotine replacement products (like nicotine patches and gum). All of the participants received weekly individual counseling for four weeks, and smoking cessation was assessed after one year. Among those using e-cigarettes, 18% had stopped smoking after a year, while only 9.9% of those using nicotine replacement therapy had quit. In short, vaping appears to be nearly twice as effective as FDA-approved smoking cessation aids.

Another U.K. study last year found that e-cigarettes can be effective substitutes for combustible tobacco products. Researchers interviewed 40 participants who had previously smoked. After being introduced to e-cigarettes, three were no longer using either tobacco or e-cigarettes, 31 had switched entirely to vaping, five were using both tobacco and e-cigarettes, and only one had relapsed back to smoking. As one of the study’s authors wrote:


“E-cigarettes meet the needs of some ex-smokers by substituting physical, psychological, social, cultural and identity-related aspects of tobacco addiction. Some vapers reported that they found vaping pleasurable and enjoyable—being more than a substitute but actually preferred, over time, to tobacco smoking.”

In 2014, researchers in Belgium studied 48 smokers who had never used e-cigarettes and were unwilling to quit smoking. The results showed that vaping was as effective as smoking a cigarette in reducing nicotine cravings and withdrawal symptoms. Eight months after the start of the study, 21% of all participants were completely abstinent from conventional cigarettes, while 23% had dramatically cut down on their smoking.

Smokeless tobacco use in Sweden and in Norway is recognized as contributing to low smoking rates and the switching of smokers to a less harmful form of nicotine. A survey found that one-third of tobacco smokers in the EU were able to stop or reduce their smoking due to e-cigarette use. Similar studies are plentiful, pointing to the value of e-cigarettes as tools in tobacco harm reduction.

Government surveys show that 2.6 million former smokers were vapers in 2016, indicating that e-cigarettes have already done a lot of good in helping smokers quit. Current smoking rates in the U.S. are at record lows for both adolescents and adults--the culmination of a sustained, decade-long decline which closely mirrors the rise in popularity of e-cigarettes.


In 2018, a study in the journal Tobacco Control projected that if cigarette use were largely replaced by vaping over a 10-year period in the U.S., as many as 6.6 million premature deaths could be avoided and lifelong smokers would live 6 months longer. That is significant.

Yes, teen vaping is a problem, but the solution is simple – increase enforcement and raise the vaping age to 21. The answer is not preventing tobacco smokers from weening themselves from a much more dangerous product.  

It’s time for policymakers and regulators in the U.S. to stop demonizing vaping and acknowledge that e-cigarettes can help millions of smokers live longer, healthier lives.

Steve Pociask is President and CEO of the American Consumer Institute, a nonprofit educational and research organization. For more information about the Institute, visit www.TheAmericanConsumer.Org or follow us on Twitter @ConsumerPal. 

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