Vaping is 95% safer than smoking. Fact or factoid?
Posted on December 23, 2019
It is often said that vaping is 95% safer than smoking. Is this figure just plucked out of the air as some critics claim or is it based on solid scientific evidence? This video and article outline the science that underpins this figure and the leading health organisations that support it.
Where did the estimate come from?
This estimate is based on comprehensive, independent reviews of the scientific evidence by both Public Health England (the English Government Public Health agency) and the Tobacco Advisory Committee of the UK Royal College of Physicians.
The Royal College of Physicians put it this way:
"Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure"
The same 95% safer figure had earlier been estimated by a group of international experts in 2014 led by Professor David Nutt. The PHE and RCP reports were completely independent of that earlier review but came to the same conclusion.
In the United States, the leading scientific body, the National Academies of Sciences, Engineering and Medicine concluded that e-cigarettes are "far less harmful" than combustible tobacco cigarettes, but did not actually give a percentage.
Of course, the exact figure doesn't matter all that much, but it helps to provide a ballpark for the level of risk which is meaningful to smokers and health professionals. Just saying it is less harmful is too vague. That could be 30% 60%, or maybe even 99% less harmful. The 95% figure helps to communicate a realistic level of relative risk that is useful.
What is the 95% figure based on?
Almost all the harm from cigarettes is due to the tar, CO and thousands of other toxins produced from burning tobacco. Vaping products simply heats a liquid into an aerosol without combustion. So it pretty clear that the risk from vaping will be much lower than smoking.
Firstly, most of the harmful toxins in smoke are completely absent from vapour. Those that are present are at much lower concentrations, mostly at levels below 1% of what they are in smoke. If the toxins are much lower than in smoke, the health risks will be much lower.
Secondly, when smokers switch to vaping, levels of toxins and carcinogens measured in the body ('biomarkers') are substantially lower and for many toxins are the same as for a non-smoker. After 15 years of vaping nicotine, there has not been one death and there are no serious health effects so far.
Thirdly, we see substantial health improvements in smokers who switch to vaping. Risk of heart attack and stroke reduces, blood pressure drops, asthma and emphysema improve and people just feel a lot better.
Fourthly, the risk of cancer has been independently estimated to be <1% of the risk from smoking.
The 95% safer figure is based on this evidence. It wasn’t just plucked out of the air as vaping critics claim.
What about long-term risks?
Like all new products, the precise long-term risk of vaping won't be known for another 20-30 years. It is possible that some harms may emerge over time and we need to keep monitoring vaping for any new side-effects.
But based on what we know about the chemicals in vapour and biomarkers, the risk is likely to be far less than from smoking which kills two in three long term users. The Royal College of Physicians estimates the long-term risk is likely to be no more than 5% of the risk of smoking, which takes into account the possibility of unknown issues that may arise in the future.
The bottom line is that vaping is not risk free and if you don't smoke you shouldn't vape.
However, if you are a smoker who can't quit you will dramatically reduce your risk of dying from cancer, heart and lung disease if you switch to vaping.
How much less risky is it? Well, at present we can say that the long-term risk from vaping is at least 95% less than smoking. But I wouldn’t be surprised if it ends up being found to be more like 98% or 99% less risky.
Critics recently attempted to undermine the claim that vaping is 95% safer than smoking. Read Clive Bates brilliant analysis of this pathetic attempt here:
Vaping is still at least 95% lower risk than smoking - debunking a feeble and empty critique. Clive Bates, Counterfactual 17 January 2020
Posted by Colin Mendelsohn, firstname.lastname@example.org