Many of the other counter-arguments are, quite frankly, nonsense. ‘Vaping is addicting a whole new generation of young people to nicotine’. There is no evidence that vaping leads to smoking. It is far more likely that there is a ‘common liability’ to try a range of substances in adolescence.
14 If it is only vaping, then why do we care about nicotine use, in itself a relatively low harm substance? Is it that, morally, we do not like the idea of dependence or is it that we struggle with harm perceptions that distort clinical reasoning? Assessment of relative risk, or relative harm, is complex. People struggle to comprehend a distant possible risk to health from vaping, even if likely very low, compared with the very high risk of tobacco smoking. This counter-intuitive position could lead people to continue to smoke tobacco, knowingly harmful, rather than switch to something that is likely far less harmful, but ‘unknown’. However, qualified clinicians should be able to think this through logically, assess the available scientific evidence and give clear advice about stopping smoking by vaping to prevent the very real risk to health that continued smoking poses to patients. We must also be clear that the harm from tobacco does not come from the nicotine. Despite this, large proportions of UK smokers and ex-smokers overestimate the relative harmfulness of e-cigarettes compared with smoking, and much of this misperception might result from views on nicotine that translate to reticence to switch to less harmful nicotine-containing products.
15
