In an article for The Conversation, Markos Klonizakis, reader in clinical physiology, discusses the benefits and risks of using e-cigarettes to give up smoking. His team is looking at the effects of vaping on small veins and arteries.

One of the most common New Year’s resolutions is to stop smoking. Quite rightly so, considering smoking is the biggest leading, preventable cause of death, worldwide. In fact, tobacco is the only legally-available product that kills up to one in every two users, when used as intended.

There are a number of ways to stop smoking. But the most common include going “cold turkey”, the use of medication – usually offered by doctors and stop smoking services – or the switch to e-cigarettes.

There’s little doubt that e-cigarettes, more commonly known as “vapes”, are less harmful than conventional cigarettes. But discussions around exactly how harmful e-cigarettes could be to users and those within close proximity, are still ongoing.

Unlike research conducted into the effects of smoking tobacco, very little is understood about any long-term health effects relating to the use of e-cigarettes. This is mainly due to the fact they are a relatively new product and researchers struggle to study people who use e-cigarettes that have never smoked conventional cigarettes.

Public Health England reports that e-cigarettes are approximately 95% less harmful than conventional cigarettes. However, professor John Newton, Public Health England’s director of health improvement, says: ‘Our position on the figure is that it is the best available published estimate. It is a useful figure, but it is not a precise scientific estimate.’

Although e-cigarettes do not contain some of the more dangerous components of conventional cigarettes – such as tar or carbon monoxide – some potentially harmful products may be present, including certain heavy metals. The lack of regulation in the industry makes the work of researchers more difficult, as differences between brands can have an impact on any research findings.

Gaps in knowledge

It is estimated that 2.9m people in the UK regularly use e-cigarettes according to a recent parliamentary report. And in 2016, The Tobacco Control Plan – an initiative from the Department of Health and Social Care which aims to reduce smoking in England – estimated over 470,000 people were using e-cigarettes as a way to stop smoking.

However, the report does not go on to say how many of those using e-cigarettes as an aid to quit smoking achieved this goal. Nor is there yet a true picture of the effects e-cigarettes can have on the small veins and arteries – in both smokers and “second-hand” smokers. These are fundamental knowledge gaps.

I am currently leading a study at Sheffield Hallam University that looks at the benefits and risks of using e-cigarettes to stop smoking. We focus on cardiovascular health, looking at the effect on small veins and arteries.

With funding from Heart Research UK, study participants have their progress monitored over a six-month period. The participants are split into three groups: one using nicotine rich e-cigarettes, another which is given nicotine-free e-cigarettes, and a third group which is provided with nicotine replacement therapy with the support of Sheffield’s stop smoking services.

All participants receive an identical type of behavioural support to stop smoking, based on the stop smoking services’ support framework. And we are still looking for people to take part in the study. Participants must be willing to give up smoking and be prepared to follow their assigned programme.

Quitting for good

The research team is measuring participants’ cholesterol levels and their nicotine dependence. We are also looking at the amount of carbon monoxide in their breath and assessing the functioning of the small arteries and veins. Results of this mini “check-up” are provided to participants as well.

Preliminary findings show that people who are randomly allocated to the e-cigarette groups are most likely not to take up smoking again and complete their stop smoking attempt, within the study course.

This supports previous work and anecdotal evidence in the field – but to make sure this is definitely the case, we are also dividing participants in each group between those who are successful and those who are not. We are assessing the reasons why the latter group didn’t complete their attempt.

It is hoped that in time, these findings will help to inform new guidelines around the use of e-cigarettes to quit smoking. Importantly, this work will also allow smokers to be given more options and be better informed, so that they can stop smoking for good.