England Study Finds No Higher Overall Illness in Never-Smoking Vapers, With Caveats

A population-based study carried out in England has found that people who use e-cigarettes but have never smoked cigarettes showed no significant increase in overall illness, or morbidity, when compared with people who use neither product.

The result is being circulated because it speaks to a question the harm-reduction argument depends on, whether the people who take up vaping from a never-smoking position are, on the whole, running a measurable health risk that the cigarette-using population carries. The study's answer is that, on the overall measure it took, the group did not stand out from those who did not use either product.

The researchers have attached the strongest caveats to that finding. The group of never-smoking vapers in the study was small, and they have said the estimate for that subgroup is imprecise, which means the result is not a confident null but a result that the data was not large enough to rule out either way. They have also said, plainly, that the study does not show that vaping is safe, and that it does not show that any of the observed relationships are causal.

The careful handling of the finding is part of what the authors are emphasizing. A small-subgroup result, reported with its limits, is being read as one more data point on the never-smoking question, not as a conclusion that the question is closed. The overall message the study sends is that no broad rise in illness has shown up in that group yet, and the follow-up will come with the larger samples that can pin the estimate down.

The result is a small piece in a larger set of findings on who vapes and what, and it is one more reason the never-smoking cohort is getting more study, not one that settles the safety question for that group.