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Giving up smoking

Electronic cigarettes

Electronic cigarettes (also known as e-cigarettes, electronic nicotine delivery systems – ENDS or ‘personal vapourisers’ -PVs) are battery powered atomisers which produce vapour by heating a liquid solution. The liquid solution usually contains nicotine with a mixture of propylene, glycol, glycerin and flavourings. Drawing air through the e-cigarette triggers the heater to create a vapour which is inhaled and exhaled the same way as smoke from conventional cigarettes. Producing nicotine vapour from a solution rather than by burning tobacco means that electronic cigarette vapour is free from some of the toxic chemicals that accompany nicotine in cigarette smoke. In Great Britain, 5.5% of people in 2017 said they currently used an e-cigarette, which equates to approximately 2.8 million adults in the population (Adults smoking habits in the UK 2017- Office for National Statistics). Action on Smoking and Health (ASH) estimates that approximately 1.5 million are ex-smokers while 1.3 million continue to use tobacco alongside their electronic cigarette use (May 2017).
 
We talked to people who had been using e-cigarettes for different lengths of time ranging from more than five years to two weeks. They all said that they used them to help cut down, or give up, smoking cigarettes (see our section on Motivations to quit).
 

Anthony decided to search for an alternative to conventional cigarettes when he developed a cough that kept him awake at night.

Anthony decided to search for an alternative to conventional cigarettes when he developed a cough that kept him awake at night.

Age at interview: 39
Sex: Male
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Ok I would say the main reason was health that I was beginning to cough a lot specifically at night time and waking up in the following morning knowing that I’d spent most of the night coughing. And this was 5/6 years ago when e-cigarettes first came out, when I was first aware of them and basically just Googled ‘e-cigarettes’ and the first website I found that looked reasonably professional I went with them and 5/6 years later I’m still with them.
 
When you were coughing did you go to the doctor’s and?
 
Well I’ve, I was diagnosed asthmatic when I was 4 but it was so mild I, look I’ve never had an asthmatic attack and I’ve never been hospitalised with it but smoking didn’t help. And I was using a Ventolin inhaler so I took. I did the yearly asthmatic review and each year it was more or less the same. ‘You’ve got a mild case of asthma and if you give up smoking it will get better.’
 
How many were you smoking sort of?
 
Oh I was at least 20 a day. I was quite heavy smoker.
 
For how long were you?
 
From the age of 17 so a good 15/20 years of smoking.
People also mentioned financial reasons for switching to e-cigarettes. Conventional cigarettes are expensive and people could save money when they changed to e-cigarettes (although clearly not as much as those who stopped altogether – see ‘Money and smoking’). Anthony, who uses a type of e-cigarette that requires pre-filled cartridges rather than liquid re-fillers, said he is vaping the equivalent of twenty cigarettes per day so financially it does not make much difference.
 

Jai compares how much money he used to spend when smoking conventional cigarettes to how much he spends now on e-cigarettes.

Jai compares how much money he used to spend when smoking conventional cigarettes to how much he spends now on e-cigarettes.

Age at interview: 43
Sex: Male
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I think it's a positive one. It's leading me in the right way. I mean, financially most people can't afford to smoke anymore; I know I can't, but somehow I seem to find the money to buy them, I've no idea how. Because when you look at what I'm spending a month and thinking, 'Where have I got that from?' You know, so yeah it's definitely a positive and I would recommend it to anybody.
 
Exactly. So, it would be monthly, on average now you're spending twenty eight pounds?
 
If that yeah. That includes the purchase of any cigarettes as well. So, if you took out… I mean there are weeks where I don’t smoke any cigarettes at all. So, if you took that out, its three pounds ninety nine a week, which is what one bottle of the stuff is.
 
OK, and before when you were just smoking, how much?
 
About sixty to eighty pounds a week.
 
Well, twenty cigarettes are anything up to about nine pounds. So, if I'm smoking twenty a day, you know? And obviously if you're going out on a… if you’ve got a weekend out, you always tend to… especially when alcohol's involved, you always tend to smoke more. So, you can… I think the worst I've been is going out for a drink and smoking forty cigarettes over a period of say eight hours, which is horrific really when you look back.
People we talked to liked the fact that they could use e-cigarettes in some places where smoking was banned or discouraged. At work, people had replaced their break time cigarette with vaping.
 

Anthony found it easy to switch from conventional cigarettes to pre-filled e-cigarettes.

Anthony found it easy to switch from conventional cigarettes to pre-filled e-cigarettes.

Age at interview: 39
Sex: Male
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I didn’t have any problems whatsoever. As soon as I had, as soon as the first, the starter kit arrived I said, ‘Oh I never need to smoke another cigarette again’ based on the first.
 
Yes, yes it was a complete 100% swap. Like the odd cigarette I did have was more out of habit as opposed to needing to but I could have just as easily have gone from one day 20 Marlborough Lights to a box of these overnight.
 
I tried the ones where you fill up, where you buy the liquid and you fill it up yourself. I tried that for a while. The issue I had with that was it didn’t look like a cigarette while this isn’t too far off. So people would have to look twice at you in the streets to realise that you’re not smoking one of those big tube things. I tried it for about six months purely for money saving and it was a lot cheaper than doing the prefilled option and I do have a cupboard with 20 bottles of the liquid so I will probably go back at some point. Someone did recommend a shop in the city centre that sells good ones fairly cheaply so I probably will go back and use that at home and use these for when I am at work or out in the evening.
 
Ok. So basically, so you have no problem with the other one, the refuel ones?
 
No, it was more of a pain and a bit messier but and the one, the like I bought two of them a cheap one and an expensive one. The expensive one I found was very badly designed and was difficult to actually use i.e. the bottom was at the top so it was harder at the front of it so it was hard to actually light it. And the other one the battery wasn’t very good.
 
Ok but in terms of the experience of smoking is it different or there is not much difference?
 
It’s different. It’s not as good. You know that you are not smoking a, you’re not smoking but the effect is very similar.
 
Like I would say they are the most expensive but are the easiest to give up on. For example I recommended it to a colleague’s husband recently and he had tried all the other types and had failed and when he started these initially three or four weeks ago he’s doing fine. He hasn’t had a cigarette since and he’s only using one carton every day and a half but he wasn’t as heavy a smoker as I was I believe.
 
Ok and you know with these have you tried to reduce the amount that you smoke?
 
No.
 
No.
 
No [laugh].
 
You don’t want, do you?
 
I never really wanted to give up smo-, ok I didn’t want to be a smoker but I didn’t want to go through the process of giving up. Does that make sense?
 
Ok. So it was just the health that was your concern and?
 
Yes and age and I’d been smoking for long enough. I had to do something.
 

Jai calculates that he is smoking less with e-cigarettes than he did with conventional ones.

Jai calculates that he is smoking less with e-cigarettes than he did with conventional ones.

Age at interview: 43
Sex: Male
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So, like the size of a packet of ten cigarettes. Now it's got a counter on the side. So, they reckon on average, it's fifteen puffs – you usually get between fifteen and twenty puffs per cigarette from a normal smoker. So, if I had one before work, one at break time, two at lunch time; so, during the day time, as a whole, during the whole day I'd smoke twenty cigarettes. On this, I'm probably up to about a hundred and sixty puffs, so divide that by twenty, so about eight to ten cigarettes I'm down to.
 
Yeah
 
So, it's actually… I am reducing… even though I vape during the day time as and when, rather than actually going outside for ten minutes and smoking solidly, which is when you end up puffing more.
 
So, yes I do use it, I wouldn’t say it's constant but it's a continuous use, but I use it less than I would do if I was smoking cigarettes.
 
OK. And do you use cigarettes on a daily basis?
 
No
 
Not now?
 
No
 
Its occasional then?
 
I'd say it's probably a couple of times a week.
Vaping does not have the ‘hit’ of smoking a conventional cigarette and some people still smoked cigarettes when they could, at home in the evenings or when with friends who smoked. However, some people were surprised at how easily they had taken to e-cigarettes and how they had cut down on conventional cigarettes. Some clearly saw this as a stepping stone to giving up smoking altogether, seeing electronic cigarettes both as an alternative and a way to gain control over their smoking.
 

Days after she took up vaping, Debbie cut down from twenty five to five cigarettes a day. She doesn’t want to become dependent on e-cigarettes because her goal is to quit smoking and vaping.

Days after she took up vaping, Debbie cut down from twenty five to five cigarettes a day. She doesn’t want to become dependent on e-cigarettes because her goal is to quit smoking and vaping.

Age at interview: 51
Sex: Female
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I started using it at the end of January yeah. And I found it quite easy as well. It took me from twenty five… I was smoking, coming up to Christmas, where I was running about and quite stressed out, twenty five. I noticed I was using more than a packet a day, so I knew that I was going to… had to stop, and I was also feeling a bit chesty at night, which I'd never had before. So, I've had… it took me to five a day within sort of using it within a few days, I found it quite easy. Yeah, it did help a lot.
 
OK. So, you have reduced quite a lot smoking?
 
Yeah, the plan is to give up completely by April, which is my birthday. I plan to come down from like twenty to fifteen, and so on but I found I was quite comfortable using it, so I just come straight down onto five.
 
OK. And was it easy to use the e-cigarette outside the home, or also in the home?
 
No, no it's easy outside. I don’t smoke anyway in… you know it doesn’t worry me not smoking in… I don’t smoke in my house, at home, I smoke outside and you can't smoke in restaurants; I don’t walk down the road with a cigarette in my hand anyway, so that side of it really hasn’t bothered me to be quite honest.
 
And how often are you using the e-cigarette now?
 
I think I have probably about five puffs out of it maybe. I try not to use it in work because I think a lot of people tell me it can become like a comfort thing, and you can be hanging onto it all the time, and then you're going to be getting more nicotine out of it, so I just tend to get it out when I would go and have a cigarette, like on my break and at lunch time and things like that.
 
OK and then the evening?
 
I'm not used to sitting down and watching TV and having a cigarette because I never smoked at home anyway, so I don’t really tend to do that either. I don’t… and it's quite a… I bought a new one now; I've sort of upgraded to the sort of better version, and it's quite heavy and chunky, so you can't really walk round with it anyway.
 
OK
 
I use it like a cigarette really; I'd use it when I fancy a cigarette.
 
But if you're at home and after dinner, do you go out?
 
Yeah after dinner, but I don’t have to go out with it obviously now. I still open the door, but it depends on what sort of flavour you put in it; some flavours like mint smells quite nice, and some people actually like the smell of it when you're smoking it. I think there's only one person that hasn’t, to date; it's a guy that used to work in here, he can really smell it and doesn’t like the smell of it, but he's the only person who's really commented on that.
 
I've bought the nicotine down because I started I think on one point eight, and then I bought it down to one point to one, and then I brought it down to zero point eight, so I've been bringing the nicotine down quite quickly in it. But I found you can get plain tobacco favour which I thought that’s what I would want to smoke, but I don’t… it was horrible, it actually tasted horrible so. I mean I tend to smoke, I think I've got mint humbug,
 
So, if you are at home do you tend to use more the e-cigarette or?
 
Yeah, yeah I still use the E because I don’t have to go out, and as I say, it's been really cold so I don’t want to go out anyway, so I'm quite happy with it. But I'm not bringing… you know like some people bring them upstairs to bed with them; I never brought a cigarette upstairs so I wouldn’t bring up with me, so I don’t think I'm getting… I don’t want to sit holding it all the time, because I have noticed a lot of people do do that.
 
And they're just puffing on it all day, and I don’t really want to get… where I've got to get off… get myself off of using that then afterwards.
Other people did not have immediate plans to stop and seemed content to replace some, or all, of their cigarettes with vaping. Finding different flavours and trying different types of vaping had contributed to some people’s enjoyment of the substitutes.
 

At first, Jai found it difficult to stick to e-cigarettes but now enjoys an aniseed flavour. He describes accessories that can make vaping more like smoking conventional cigarettes.

At first, Jai found it difficult to stick to e-cigarettes but now enjoys an aniseed flavour. He describes accessories that can make vaping more like smoking conventional cigarettes.

Age at interview: 43
Sex: Male
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I've been smoking for about twenty five years I suppose; tried most things on the market – the patches, the chewing gum – pretty much all of them, and they worked for a certain period of time and then you always end up going back to cigarettes, or I always end up going back to cigarettes. With these, I still do smoke, but probably about five to ten a week, in comparison to twenty a day.
 
So these really are helping. And, the thing is it's a learning curve, because there's so many different flavours in the market, you find ones that suit you; ones that don’t, you end up smoking, going back to smoking quicker. So, I did start on these last year, and they were OK but they wasn’t completely successful, but as I've tried different flavours, I'm introducing the vaping more and more, rather than staying on cigarettes.
 
OK. And did you combine the filling with nicotine and flavours or?
 
Yeah, I buy the pre-mix ones, so I started at the highest level and I'm about half way through now.
 
So, what's the highest level?
 
I believe it's about twenty eight milligrams, I think it is.
 
Of nicotine?
 
Of nicotine, and I'm down to eighteen now.
 
OK
 
And then the next level's eleven, then eight, and then zero, so I'm working my way down, and smoking these more.
 
The e-cigarette. So, for how long have you been using the e-cigarette?
 
On and off since about September, but since Christmas I've been using it pretty much every day.
 
OK, when you say on and off…?
 
As in, smoke for one day, two days e-cigarette, and then back to smoking, so it just varied as and when I used it. But like I said, that’s down to flavour choice, because I found one specific flavour that I will happily smoke all the time, but the problem is, because you order it online I tend to run out, and if they haven’t stocked it, because it is very, very popular.
 
And which flavour it is?
 
Aniseed
 
Aniseed?
 
R:         Yeah
 
OK. So, it's a combination of aniseed and nicotine?
 
Yes
 
So, was it easy to get used to…
 
I found it tricky because of the flavouring. It's completely different. Where, smoking cigarettes is a warm, moist smoke, these are very dry, so you do notice the dryness of the mouth, and you can get a case of a dry… you do have a dry cough, but it's not continuously, like occasionally you'll just cough, but it's a dryness, so you do end up drinking a bit more water or whatever, because they are… the vapour's very dry. I think that’s what can put people off; is the fact that you're used to that warm, moist smoke, but this is...
 
A dry one
 
A dry one. But you can, like I say, with some products you can actually warm the vapour up, which does help.
 
And where did you get those products and…?
 
On the internet again.
 
OK, and what are they called?
 
They're called mods, because it's a modification. This is like a standard e-cigarette, but you get these things called modifications, where you put the same top on but it's the bottom bit where you can adjust the power, the wattage, and which can then generate heat to let you have that warm vapour.
 
OK, so it simulates more the-cigarettes?
 
It simulates… yeah, so that… it was fairly low cost compared to what some… I mean you can go from these, about ten pounds, up to six hundred pounds so.
 
Oh gosh [laughs].
 
But, if the six hundred pound gives you the result that you want which is not smoking, and I think that’s definitely a benefit, because you'll probably spend more than, far more than six hundred pound a year on smoking so.
 

Rosanna compares smoking a conventional cigarette and an e-cigarette. She thinks that it is a question of habit forming and hopes that soon she will get use to vaping only.

Rosanna compares smoking a conventional cigarette and an e-cigarette. She thinks that it is a question of habit forming and hopes that soon she will get use to vaping only.

Age at interview: 56
Sex: Female
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Yes, it’s hard to describe really because you’re actually inhaling whatever it is, the vapour. But when you’re, when you’re using, when you’re smoking a cigarette you, there’s a certain, when you, when you inhale, you kind of get, I don’t know if you could describe it as a bit of a head rush or something. But it’s something that you get when you inhale a cigarette that it’s not really the same when you’re smoking an e-cigarette.
 
I think in terms of a ritual thing, you’ve got a sort of an inhale, an inhalation and then, you know, the blowing out of the smoke and the kind of the look and to an extent, especially if you, if you choose a tobacco flavour, then you’re getting that, the sort of the taste. But there’s just something about, about it that perhaps doesn’t reach the parts that a cigarette does.
 
Maybe it’s in the brain I don’t know. It doesn’t feel quite the same. You know, you’re kind of, you know you’re smoking a substitute. If somebody gave, if I was blindfolded and I didn’t realise which one it was, I think I could tell quite easily. So yes, it’s definitely not the same. But as with anything that you become accustomed to then I guess after a time, maybe that wouldn’t matter so much. So I think at the moment where I’m at, I’m in the initial stages and I’m noticing the difference. But people have told me who’ve stopped smoking all together, that then they’re not comparing, so.
 
Okay, so another kind of behaviour pattern sets in.
 
Yeah, well it does take time I guess for your brain to adjust to what you’re, what you’re doing.
 
And I can’t say it’s like smoking. I don’t feel it’s a, you know, an equivalent because really it doesn’t give you the same kind of hit that you get from a cigarette, but it’s not bad and, I think, I’m starting to get more used to it now. But I’ve been using it initially in combination with cigarettes but using it to cut down. So during the day I might instead of going out and having a couple of cigarettes while I’m at work, or if I’m at home during the day, I’ll probably smoke more. So I tend to use the e-cigarette during the day if I feel like I want a cigarette.
 
So I think it’s helped me to stop smoking during the day.
Not all electronic cigarettes include nicotine; some simply produce vapour for inhalation, but these do not seem to be as popular. People we talked with have been reducing the nicotine dose and some would like to reached the minimum dose, while others planned to replace nicotine altogether and end up vaping just water.
 

By chance rather than choice Jai reduced the nicotine dose. Ideally, he would like to bring down the nicotine dose to zero and then, to stop smoking all together.

By chance rather than choice Jai reduced the nicotine dose. Ideally, he would like to bring down the nicotine dose to zero and then, to stop smoking all together.

Age at interview: 43
Sex: Male
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So, you tried different flavours and aniseed is the one that worked for you?
 
For now yes
 
OK. And at what moment do you start reducing the amount of nicotine on the vapour?
 
I'll be honest with you, it was more luck than judgement because the high strength one they didn’t have, so I had to go to the lower strength, in the aniseed, and then I've just stuck with that.
 
The main two flavours I use are aniseed and menthol, or mint flavour. Now, the mint flavour, because it gives you quite a sharp hit… you know, like extra strong mints, it gives you quite a strong hit in the back of your throat. So, I'm on eleven milligrams with my mint. So, so some flavours do vary, but generally, yes I am working my way down. Ideally, I want to get to not using it at all, but I have to lower myself down. Ideally, I'd like to probably stay on the zero for a few months before I realise that my body doesn’t actually need that; it's just a habit of using this you know. So, zero, but ideally not nothing at all. So, I'm on my way down but I'm not there yet.
Among the people we talked with, only Debbie talked to her GP and local pharmacists before starting using e-cigarettes. More commonly, people found information online, or talked to a family member, or friends or colleagues who were already using e-cigarettes.
 

Rosanna’s son showed her information online about e-cigarettes and told her about his experience of using one. She also got information from the e cigarette store she used.

Rosanna’s son showed her information online about e-cigarettes and told her about his experience of using one. She also got information from the e cigarette store she used.

Age at interview: 56
Sex: Female
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And then my son came to stay with me a few months ago, and he was a smoker, but had tried, was using e-cigarettes at the time when he came to stay. And I was quite curious about them because it’s, they’re quite new, and I didn’t really know much about them other than that people could use them to try and stop smoking. So when he came it gave me an opportunity to sort of have a few puffs and try it. And I can’t say that I was particularly impressed but he was saying that after a few days he’d got used to them. So it just got my mind thinking about, you know, ‘Oh, well maybe I could try that route.’
 
And it was also helpful talking to him because he’d already bought some because he knew, it was, it was a bit of a mystery as to what do you buy and what bits and pieces do you need and how do they, how do you set them up? You had to plug them in and thinks like that and I, I’m not that technical, technically orientated so I, it just all seemed like a bit like too much hard work. But because I was with him and sort of told me what he’d bought, in fact, we went on line and he showed me all the different bits and pieces that you need on a website. So I got more of an idea of what I needed to do, which made it a bit easier I think. And then around about Christmas time I decided to go and buy an e-cigarette and try it out. I thought, ‘Well, I might just as well give it a go and see, see how I get on. There’s no harm in trying.’
 
And my son came to stay with me, stay with me again recently and he said that, “He and his girlfriend had smoked these e-cigarettes for a while and now they don’t even bother with that and they tried cigarette, you know, a week or so ago and both decided it was horrible and they didn’t want to smoke. So it seems to have been quite successful for him in actually stopping.
 
 

Debbie told her GP and pharmacists about her intention of using e-cigarettes and got two different opinions.

Debbie told her GP and pharmacists about her intention of using e-cigarettes and got two different opinions.

Age at interview: 51
Sex: Female
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I did tell my GP that I was doing it; she was quite happy about it. I mean she did offer for me to go to the smoking clinic, but I did find it hard to get there when they wanted me to go. I've had patches, but I was allergic to them, they brought me out in a rash, and I was a bit worried about trying the tablets because I've got like a tummy ulcer and I can't take Ibuprofen and people said that they'd been quite sick. I got hypnotised, I've been hypnotised when I was pregnant – that worked. That was like aversion therapy, so I thought it was just worth a try. But I think I am ready to give up now because you get to a certain age and I don’t want to be still smoking in ten/twenty years' time to be quite honest. I don’t like being addicted to anything, and it's really the only thing that’s really… like drink doesn’t bother me; anything else and it's sort of the only thing that I seem to sort of have issues with so, I won't let it beat me.
 
And where did you get your information from about e-cigarettes?
 
Mostly online.
 
Online?
 
Yeah. I sort of looked, and I have looked and obviously I did ask the GP about it. She said you know that they're not really sure what the risks are with them yet, but it's better than smoking; and she was my mum's GP as well, so she's really happy that I was doing it.
 
And I had a meeting with the pharmacy; you know when they bring you in and just discuss your drugs and what you're on. They're not sort of very happy with them [e-cigarettes] at the moment, the pharmacists, they prefer you to…
 
No?
 
No, they want you to smoke those other ones. You know, like the cigarette type… because my one is like this, it's… But you know like the plastic cigarettes sort of type ones that you put the cartridge in. They think that they're safe, are those. They said these are not really tested at the moment, but what I've… sort of information I've got online, you know they're better than cigarettes anyway you see.
Recent research shows, “Respondents who reported having used an e-cigarette in their most recent attempt to quit were more likely to report still not smoking than those who used NRT bought over-the-counter or nothing.”**.
 

Debbie feels confident that she will be able to quit smoking cigarettes. Her mother died of lung cancer so she is aware of the risks.

Debbie feels confident that she will be able to quit smoking cigarettes. Her mother died of lung cancer so she is aware of the risks.

Age at interview: 51
Sex: Female
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How do you feel about the prospect of being successful at…?
 
Yeah, I'm looking forward to it. As I said, it is the only thing that’s really sort of caught me, I'd say in my life, and it's… and I don’t really like the idea of, you know, not wanting to smoke but still having to. So, yeah so I will beat it.
 
Why do you think you were able to stick to e-cigarettes so fast, and reduce the nicotine levels and everything?
 
I think because I wanted to, because I was coughing at night and I just wasn’t feeling right. I'm getting older and I didn’t feel… I mean my mum, as I told you, had cancer, and I knew she wasn’t well by listening to her breathing at night and things like that; I sort of knew there was something not right a long time before she was diagnosed, and I don’t want to get, you know… because she was told to give up years ago, she was told to give up when she was fifty/fifty five/sixty – she kept going to the doctors, chest infections and what not – and I think if she'd have given up a lot earlier, then maybe she wouldn’t have ended up with what she had, and I don’t really want to get in that situation if possible.
 
Yeah
 
Not that you cannot get something else, but it's another specific risk really.
Since 2016, e-cigarettes have been classed as medicines by the UK Medicines and Healthcare products Regulatory Agency (MHRA), which mean that e-cigarettes are required to be manufactured to medicinal purity and delivery standards. In other words, they undergo rigorous tests, and are subject to proactive controls on advertising. This move has been widely welcomed by medical experts and officials, as tighter regulation will help control safety and efficacy. Until 2016 e-cigarettes are only covered by general product safety legislation, which meant they could legally be promoted and sold to children, and the ingredients and amount of nicotine contained within each e-cigarette could vary. People we talked with were aware that there is a lack of medical research and reliable information about possible long-term health impacts, although reasoned that e-cigarettes were bound to be less harmful than smoking. Jai and Anthony have used e-cigarettes for quite a while and commented on the health benefits they have noticed since replacing their cigarette smoking with vaping.
 

Anthony no longer coughs at night, nor does he need his asthma inhaler as much as he used to. He feels lucky to have succeeded in replacing cigarettes for what he feels is a healthier option.

Anthony no longer coughs at night, nor does he need his asthma inhaler as much as he used to. He feels lucky to have succeeded in replacing cigarettes for what he feels is a healthier option.

Age at interview: 39
Sex: Male
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Do you use the inhalers as much as you used to do when you were?
 
No not any more no. I’m down to about once a day as opposed to two, three times a day.
 
Ok. And your cough how is your cough now?
 
Much better. I would, I would rarely cough. I only cough at night time. I might wake up in the morning like 8 o’clock and be a bit tight around the chest but and out of habit would take a blast of the inhaler but I wouldn’t be in any stress or discomfort well minor discomfort just a bit of chesty, oh bit of tightness around the chest.
 
So you haven’t had any kind of asthma attacks or felt unwell with?
 
Well I never even had a, I never had an asthma attack when I was smoking. It was just the tight, the tightness gets more restrictive when you just reach for the inhaler.
 
Ok. So would you say that you have quitted cigarettes?
 
No, no I’ve replaced it with an alternative which is much better as in its healthier. It’s cleaner. It doesn’t smell. You can smoke it in hotel rooms and the like but it is. If I didn’t have the box of E [brand name] then I would have to buy a packet of cigarettes within two hours.
 
Ok. Do you think that you might want to stop smoking e-cigarettes in the future?
 
Yes. And then it would be kind of more financial reasons because the health issues have gone and so it would just be financial would be the incentive.
 
I was lucky that I found a good brand that worked for me and I think that is key to it because I’ve heard so many stories of people buying their e-cigarettes that you can, you see popped up being sold in newsagents and haven’t had as much success. So I suppose it’s a bit like back 10 years ago before e-cigarettes when your options were patches, gums and try to work out what works for you and then you’d have a lot more success. But if you just... There is a big step from going from a smoker to someone who has, doing nicotine replacements. You have to find what works for you. And in a lot of cases it’s the most expensive option, you know. So if giving up smoking for financial reasons is your motivation then you might as well just go cold.
 
Would you advise people who are smoking to try an e-cigarette?
 
Yes, yes highly. Yes.
 The safety and long-term safety of e-cigarettes is currently a hot topic for researchers. E-cigarettes do contain chemicals and other toxins which are associated with an increase in the risk of developing cardiovascular problems and lung diseases and so should not be promoted as safe/risk free or for use by non-smokers. The World Health Organisation advise against using e-cigarettes indoors or in enclosed spaces, until the exhaled vapour is proven to be not harmful to bystanders although they do recognise that “ Switching from smoking tobacco cigarettes to using e-cigarettes – known as vaping – may reduce user harm, by supporting quitting or acting as a lower risk substitute. However, the degree of harm reduction is uncertain.”***

*Dockrell, M., et al., E-Cigarettes: Prevalence and Attitudes in Great Britain. Nicotine & Tobacco Research, 2013. 15(10): p.1737-1744.
**Brown, J., Beard, E., Kotz, D., Michie, S. and West, R. (2014), Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction, 109: 1531–1540. doi: 10.1111/add.12623
*** Bulletin of the World Health Organization 2017;95:540-541. 

Last reviewed August 2018.
Last updated August 2018.
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