An increasing number of smokers believe that e-cigarettes are just as harmful as ordinary cigarettes. In the UK, the proportion holding this view has more than doubled in ten years. Now, both British public health experts and the authors behind Global State of Tobacco Harm Reduction on how research into risks is presented and has an impact in the media.
Public awareness of the difference in health risks between smoking and vaping has declined sharply in the UK. This is shown by a new survey from the organisation Action on Smoking and Health (ASH), which has been highlighted by The Guardian.
In the survey, carried out by YouGov amongst just over 13,000 British adults, 54 per cent said that vaping is just as harmful or more harmful than smoking. Amongst those who smoke themselves, the figure was 52 per cent.
Among smokers who had never used e-cigarettes, the figure rose to 61 per cent. Fewer than a third of smokers said they believed vaping posed fewer health risks than smoking. Ten years ago, around a quarter of the adult population considered vaping to be as harmful as, or more harmful than, cigarettes.
”A far cry from what the evidence shows”
Hazel Cheeseman, Chief Executive of ASH, describes the situation as worrying.
“It is worrying that the public’s perception of vejpning is now so far removed from what the evidence shows,” she tells The Guardian.
According to ASH, this change in risk perception may have practical consequences. People who believe that vaping is just as harmful as smoking are less likely to use e-cigarettes to quit smoking. Furthermore, in the survey, nearly one in five people who mentioned a method for giving up vejping stated that they had used cigarettes to do so.
Studies on risks are having a major impact
However, it is not just media coverage that is being singled out. Jamie Brown, a professor and head of the Tobacco and Alcohol Research Group at University College London, notes that the causes behind this trend are difficult to distinguish. At the same time, he highlights the way in which research findings on e-cigarettes are presented.
According to Brown, a large number of scientific studies have reported potential health risks associated with vejpning without, at the same time, comparing them with the risks of smoking. These studies subsequently often receive a great deal of media attention.
“The result is that, over the past 10–15 years, people have seen a lot of news stories focusing on the risks associated with e-cigarettes without putting them into context in relation to how harmful cigarettes are,” says Jamie Brown.
Hazel Cheeseman also points to the same chain of events. According to her, one driving force behind this trend is the extensive media coverage of studies that identify potential risks associated with vejp use, whilst failing to highlight the significantly greater risks associated with smoking.
The same trend is highlighted in a new global report
The role of the media is also discussed in the recently published Global State of Tobacco Harm Reduction 2026. As Vejpkollen has previously reported, the authors of the report estimate that around 200 million people now use smoke-free nicotine products. At the same time, they describe misconceptions about the relative risks of these products as a growing problem.
This is particularly evident in the case of e-cigarettes. According to the report, news stories about potential health risks have often had a major impact, whilst comparisons with smoking have taken a back seat.
– The media rarely present smoke-free nicotine products as a way for adults to quit smoking, but rather as a risk to young people. This distorts the public’s perception of risk and may discourage behaviours that might otherwise be beneficial, the report’s authors write.
The report also examines how research findings reach the media. Among other things, the authors highlight press releases in which sensationalist phrasing can exaggerate the findings, whilst methodological caveats and contextual details are lost in the subsequent reporting.
They also highlight two periods when attitudes towards vejpning changed particularly markedly. The first followed the EVALI outbreak in the US in 2019, which was long associated with vaping in general, even though the lung damage was later linked to vitamin E acetate in illegal THC products. The other coincides with increased media focus on young people’s use of e-cigarettes from 2021 onwards.
– ‘Reports that broadly equate vejpning with smoking have caused confusion amongst the general public in many countries,’ the authors write.
The risk profile may influence the decision to give up smoking
At the same time, the issue goes beyond how people respond in opinion polls. GSTHR refers to British research in which smokers who assessed vaping as less harmful than smoking were subsequently also more likely to have switched from cigarettes to e-cigarettes. Overall, the report’s authors describe inaccurate risk communication as a measurable barrier to the transition from smoking to less harmful alternatives.
This is happening at the same time as the evidence for e-cigarettes in smoking cessation has been strengthened. The latest update to Cochrane’s Living Review continues to conclude that nicotine-containing e-cigarettes help more people to stop smoking than traditional nicotine replacement therapy. The GSTHR also cites Cochrane’s conclusion as evidence with a high level of certainty.
The issue of how relative risks are communicated has also been highlighted previously. Last spring, it was reported that Vejpkollen on an open letter from around thirty European researchers and public health experts. They criticised statements made by the EU Health Commissioner, Olivér Várhelyi, in which the risks associated with smoke-free nicotine products were equated with those of smoking.
‘But there is a significant difference between describing something as equally harmful and as less harmful,’ the researchers wrote.
”Has real consequences”
For Hazel Cheeseman at ASH, this decline in risk perception is therefore not merely a communication problem.
– For smokers, these misconceptions have real-world consequences. If someone believes that vaping is just as harmful as smoking, they are less likely to use it to quit smoking and more likely to stop vaping and go back to cigarettes. Both outcomes are significantly worse for their health, she says.
