Imagine you’re looking for a reason to ban vaping in public places. No, really, put yourself in the shoes of somebody in that position.
The best approach is clear.
With an air of confidence, you say, “Vapers expose non-users to harmful chemicals and nicotine,” (taking care to say “chemicals” like it’s a dirty word).
But, just as you’re patting yourself on the back, an advocate responds:
You’re stumped. Without the health argument on your side, what can you say?
It would look too unreasonable to just say you don’t like people doing it. They might not like you wearing so much aftershave, but asking you to stop would be a bit much.
Well, seeing somebody vaping will renormalize smoking-like behaviour!
It seems to have hit home, so you continue:
E-cigarettes make smoking seem acceptable, like inhaling nicotine is totally normal behaviour… In fact, e-cigs could do more harm than good by re-normalizing smoking!
You’ve done it: even if people aren’t quite sure how this mythical “renormalization” works, you’ve made it sound pretty serious.
It didn’t even take a scrap of evidence, either, just a few carefully-chosen words.
So, how should our fictional advocate respond to this claim? Is vaping really renormalizing smoking? What does the evidence say?
Well, thankfully for us vapers, the evidence doesn’t really support such an idea at all: in fact, plenty of research – not to mention good old common sense – suggests that the exact opposite is happening.
Here are 10 reasons vaping is de-normalizing smoking, not renormalizing it:
1. Smoking is Already Pretty Normal
There are about 10 million adult smokers in the UK, meaning that one out of every six adults smokes.
What classes as “normal” is up for debate, but this would make smoking much more common than having red hair or diabetes, for example (both of which would hardly be called “abnormal”), and would mean there are as many smokers as there are people aged 65 or over, so saying that it’s been “de-normalized” in the first place is a bit of a stretch. Smokers may have to stand outside now, but there are still quite a lot of them!
2. Smoking and Nicotine Use are Declining
If vaping were renormalizing smoking, one thing you’d definitely expect is for the number of smokers to be increasing.
Data from the Smoking Toolkit Study and the Office for National Statistics (ONS) shows that this isn’t the case: smoking rates are continuing to decline as vaping becomes more popular, and are currently at the lowest levels ever recorded in the UK.
Not only that, the rate of overall nicotine use (including e-cigs) is also on the decline.
3. Most Vapers are Trying to Quit or Cut Down Smoking, Not Avoid Smoking Bans
One of the main concerns about the renormalization of smoking is that people are vaping indoors, as if they’re using e-cigs as a loophole to get around the smoking ban, which was a crucial step towards de-normalization.
However, ASH UK’s survey on e-cigarette use shows that most vapers started to either quit smoking or to smoke less, with only 25 percent of vapers who also smoke and 11 percent of ex-smoking vapers saying they vape to avoid smoking bans.
Additionally, surveys of vapers show that only 7.5 percent say they vape anywhere they like, with the remainder only doing so outside or if explicitly given permission to vape indoors.
4. More People are Successfully Quitting Smoking
If vaping renormalized smoking, you’d expect to see less people successfully quitting, but the Smoking Toolkit Study shows that the percentage of smokers quitting each year is at its highest since 2007.
In 2007, 6.7 percent of smokers quit, and this gradually decreased to 4.6 percent by 2011. Since then – as more people started vaping – the rate of quitting increased, reaching 7.2 percent in 2014 and still standing at 6.6 percent in the first quarter of 2015.
Additionally, the rates of success for smokers trying to quit increased sharply in 2012, and in 2014 reached 19.1 percent – the highest successful quitting rate since at least 2007.
5. Almost All Vapers Are Smokers or Ex-Smokers
If vaping was being taken up by large numbers of non-smokers, then you could argue it was renormalizing nicotine use in society. But the evidence doesn’t support this idea at all.
The Smoking Toolkit Study, ONS data, a recent survey from Cancer Research UK and ASH UK’s surveys (of adults and of children) all strongly suggest that the number of never-smokers taking up vaping is very small or even non-existent.
Around 0.2 percent of never-smoking adults are current vapers, and both Cancer Research UK and ASH’s youth surveys found no evidence of children who’ve never smoked becoming regular vapers.
Professor Robert West, who worked on the Smoking Toolkit Study, commented that,
Some public health experts have expressed concern that widespread use of e-cigarettes could ‘re-normalize’ smoking. However, we are tracking this very closely and see no evidence of it. Smoking rates are declining, quitting rates are increasing and regular e-cigarette use among never-smokers is negligible.
6. The Rate of Starting Smoking Has Remained Stable
Over 80 percent of smokers get started before age 20, so if more young people were starting to smoke since e-cigs became popular, we could have a problem on our hands.
However, the percentage of under 25s who’ve ever been regular smokers has remained stable, hovering at around 30 percent since 2011, according to the Smoking Toolkit Study.
7. There is No Evidence of a Gateway to Smoking
As the record low smoking rates and low to non-existent levels of vaping in non-smokers suggests, the idea that vaping is a gateway to smoking is fairly unlikely: it’s more like an exit from smoking.
A study looking specifically at whether vaping or other nicotine products are gateways to smoking found no evidence of such an effect from vaping: out of around 1,300 university students, only 59 started to use nicotine with an “emerging product” (including e-cigs) and just one of these ended up as a daily smoker.
8. Dual Users Cut Down their Smoking or Eventually Quit
If vaping made nicotine addiction even worse and encouraged smoking, the fact that “dual use” (both smoking and vaping) is common could mean e-cigs are slowing down the de-normalization of smoking.
However, user surveys suggest that dual users actually end up smoking a lot less – going from an average of 20 to just 4 cigarettes per day – and almost half of them stop using tobacco cigarettes entirely within a year.
Additionally, vaping appears to reduce nicotine addiction, not strengthen it. Professor Jean-François Etter, lead researcher on these last two studies, said that:
Dual use seems to have two consequences: reduced smoking, and eventual smoking cessation (in about half the dual users after one year in our data). This suggests that dual use should be considered positively.
9. Most Vapers Don’t Use Cigalikes
The renormalization argument is dependent on the idea that e-cigarettes can easily be confused with cigarettes, because this is what gives them the supposed ability to make smoking seem more normal.
While this may have been true four or five years ago, the reality today is very different indeed: the majority regular users do not vape from a cigarette-like device.
ASH UK’s survey shows that around 66 percent of regular vapers in Britain use tank systems, which look about as much like cigarettes as Kindles look like books, and previous research puts the figure even higher than that.
10. E-Cigarettes are a Product of the De-Normalization of Smoking
In a New England Journal of Medicine “Perspective” article looking at e-cigarettes and the renormalization of smoking, the authors raise a crucial point: the appeal of vaping is completely dependent on the fact that smoking is looked down upon in society.
Vaping is a product of de-normalization: a reduced-risk alternative that also doesn’t stink out rooms and contribute to litter-filled streets.
A vaper in a public space isn’t renormalizing smoking; he or she is sending out the message:
I know smoking is bad and I shouldn’t be doing it, but I have difficulty quitting nicotine entirely, so I’ve switched to doing this instead.
In other words, vaping is further de-normalizing smoking, by giving those who can’t quit nicotine a non-combusted alternative.
Conclusion – Vaping Can De-Normalize Smoking, if You Give it the Chance
Despite the concern about the “renormalization” of smoking, the evidence seems to show that something that is clearly not smoking doesn’t renormalize smoking at all.
In other words, our fictional advocate would have plenty of valid points to draw upon in such a debate.
E-cigarettes, despite their appearance, are a new tool to aid in the de-normalization of smoking, not a Trojan horse it’s using to worm its way back into society.
Want to read more? Check out our infographic: Are electronic cigarettes a gateway to smoking?