E-cigarettes: the need for clear communication on relative risks

The Lancet Editorial criticises our Public Health England commissioned evidence update report on the basis of perceived flaws in one of the 185 references we used, ignoring the rest of our 111 page document, which addresses population effects of e-cigarette use, regulations, attitudes as well as concerns over its safety. The Editorial focuses on the estimate of risk reduction and protests strongly against the media reassuring smokers that switching to e-cigarettes provides substantial health benefits, but it provides no data to counter our estimate, nor any reason as to why The Lancet believes that the message smokers can benefit from switching to vaping is an undesirable one. The estimate that e-cigarette use is around 95% less harmful than smoking is based on the facts that: first, cigarette smoke constituents that harm health are either absent in e-cigarette vapour or, if present, are mostly at levels much below 5% of smoking doses; and second, the main chemicals present in e-cigarettes only have not been associated with any serious risk. Our review highlighted how smokers are currently misinformed about these relative risks. We would encourage people to read our full report before criticising it. Current evidence indicates that smokers who switch from smoking to e-cigarettes reduce the risks to their health dramatically. We believe this needs to be communicated and that undermining this message will keep smokers smoking and dying as a result.