Why public messaging must be clearer on vapes, e-cigarettes

 FMT takes a closer look at how language shapes these messages and what it could mean for smokers trying to quit.

As nicotine products have evolved, confusion has grown over whether alternatives such as vapes and e-cigarettes are more or less harmful than smoking.

PETALING JAYA:

 Public health messaging about tobacco has long been simple and effective: smoking kills.

However, as nicotine products have evolved, confusion has grown over whether smoking alternatives such as vapes and e-cigarettes are more or less harmful than smoking.

FMT examines the consequences of unclear messaging and how it may be undermining efforts to help smokers quit.

Why language matters

Dr Rashidi Mohamed Pakri Mohamed of Universiti Kebangsaan Malaysia says the confusion has real consequences for smokers trying to quit.

He said a key issue is that combustible cigarettes and vaping devices are often grouped together under broad terms such as smoking or alternative smoking products, making it harder for smokers to distinguish between the risks.

“There is a growing number of people, including smokers, who now believe that vaping is equally or more harmful than smoking,” he told FMT.

Hayden McRobbie, a leading tobacco dependence researcher, agreed, noting recent studies showing that public perceptions are moving in the wrong direction.

“Trends in perception of harm are going the wrong way. There’s an upward trend in people believing that e-cigarettes are more harmful than smoking, and a downward trend in people believing they are less harmful,” McRobbie said.

A study published in Jama Network Open found that 57% of adults who smoke in England believed in 2023 that e-cigarettes were equally or more harmful than cigarettes.

However, according to the World Health Organization, cigarette smoking harms health mainly because burning tobacco produces thousands of toxic chemicals, hundreds of which are known to be harmful or carcinogenic and contribute to cancer, heart disease and chronic lung conditions.

Meanwhile, the UK’s National Health Service notes that while vaping is not risk-free, it does not involve combustion and exposes users to significantly fewer toxic substances than cigarette smoke, resulting in lower exposure to many of the toxins linked to these diseases.

“Evidence has shown up in recent publications that using e-cigarettes is even more beneficial than using nicotine replacement therapy to help smokers quit smoking.

“So these are the things that we need to look into because the messaging may not be as clear to the public as intended,” Rashidi said.

McRobbie said recent studies also suggest that the misperception is not evenly distributed, with smokers in lower socio-economic groups more likely to believe that e-cigarettes are equally or more harmful than combustible tobacco.

“The people that need our help most, including those from lower socioeconomic groups, are the ones that are holding these misperceptions,” he said.

A medical vape pathway

Rashidi said clearer messaging must be paired with stronger regulation if vaping is to function as a genuine smoking cessation tool.

He proposed that the government consider developing a regulated medical vape pathway, in which devices are monitored and prescribed in a controlled manner rather than sold as open recreational products.

Under this model, e-cigarettes would be equipped with built-in micro-technology to monitor nicotine intake, usage patterns and user authentication.

Rashidi said that integrating sensors and connectivity features, similar to those used in consumer electronics, could transform vaping devices into part of the Internet of Medical Things, enabling clinicians to monitor progress remotely.

“This solves major policy concerns regarding youth access or device sharing.

“Moving from open-system vaping to a monitored, closed-loop system would give us data and accountability. It turns vaping from an uncontrolled habit into a measurable cessation strategy,” he said. - FMT