Vaping – The Final Nail in the Coffin for Smoking?

Do e-cigarettes herald the end for smoking? Expert Karl Fagerström, winner of a World Health Organisation medal, certainly thinks so. The Swedish psychologist believes this following a comprehensive review of the data surrounding alternative nicotine product adoption in countries around the world and compared this to the smoking rates in those countries.

Karl Fagerström is a highly respected expert. He invented the Fagerström Test for Cigarette Dependence and got his doctorate with a dissertation about nicotine dependence and smoking cessation. Through his involvement with Nicorette, he helped to develop nicotine patches, sprays, pouches, and inhalers. He has published 180 peer-reviewed pieces of research and scientific papers and, in 1999, was awarded the World Health Organization medal for outstanding work in tobacco control.
 
Safe to say, Karl Fagerström knows his onions regarding quitting smoking and electronic cigarettes.

The expert says that “tobacco control is not working for most of the world”. The statement comes from the fact that in thirty years the overall number of tobacco users has barely changed.
 
He cites Vaughan Rees damning the old ways of doing things: “The best, evidence-based interventions are dated, overrated and cannot meet the challenge of reducing tobacco-related harm in this century.”
 
Sailing against this tide, Fagerström points to New Zealand and us here in the United Kingdom. He highlights that the Kiwi and UK governments “explicitly encourage the use of vaping for smoking cessation and harm reduction”.

Mr Fagerström says that although the UK already had a lower smoking rate than most of the 27 countries in the EU in 2014, by encouraging smokers to switch to vaping, the UK has seen a four-point percentage drop in smoking. Meanwhile, the EU was less welcoming to electronic cigarettes and consequently experienced a decline in smoking at half the rate we enjoyed.
 
New Zealand experienced similar, where daily smoking prevalence has fallen faster than in neighbouring Australia.
 
 Karl Fagerström says that the data reviewed in his research paper indicates substituting smoking products with vaping products appears to be directly linked to lower smoking rates.
 
“This is supported by the lower smoking prevalence in countries with relatively high uptake of alternatives compared to neighbouring countries with lower use of these products. The findings indicate that more rapid adoption of alternative nicotine products may help reduce smoking prevalence faster than traditional tobacco control measures focused on prevention and cessation alone,” he says.
 
He points out that the data shows the decline in smoking in countries embracing vaping is being driven by young adults who are no longer being locked in to a lifetime of smoking.

He adds: “If current trends persist, it is likely that in countries that have reached very low levels of smoking among youth and young adults, smoking will virtually disappear in one or two generations as these cohorts reach adulthood. However, more could and should be done to reach this objective even faster and in more countries.”
 
Karl Fagerström calls for bolder policies from all countries to include the endorsement of harm reduction. He says this is needed “to put the final nail in the smoking coffin.”