What Is the Value of Peer Involvement in Advancing Tobacco Harm Reduction?

Summary of Study

Bottom Line: E-cigarette users are valuable in advancing tobacco harm reduction. They demonstrate the benefits of e-cigarettes, including health improvement, ease of maintaining nicotine levels without flouting local policy, financial savings and a tool to maintain a smoke-free life. The pace of e-cigarette adoption would not have happened if early adopters had not been champions. Such examples of how peer influence can have an impact on real-world outcomes should be a positive trigger for other research departments to adopt the expertise of those with lived experience. 

The involvement of peers is shaping smoke-free policies by advising on approaches to supporting vaping as a smoking cessation tool. Further examples of peer involvement in advancing tobacco harm reduction can be seen among sub-groups where rates of tobacco smoking are much higher than the general population.

In the UK, the peer involvement approach has also extended to stop smoking services, who have increased their enthusiasm for listening to and working with vapers. In Leicester, for example, adoption of an action-based research model was influential, where vapers were invited to team meetings and were surveyed post-quit to establish what particularly it was about the vaping experience that meant this quit was more successful than previous attempts (‘I don’t know, it just looked like smoke, and that made me feel happier’). Initially suspicious of e-cigarettes in 2014, the team shared feedback from users, becoming more confident to be bolder in talking about vaping.

Vapers are becoming stop smoking advisors. Unlike those who had quit smoking with licensed medication, those who quit with vaping became powerful advocates for switching among their friends and family, sharing their devices and giving encouragement to those still smoking to try vaping. Evidence from stop smoking services in England demonstrates superior quit rates among those who chose a non-licensed product, of between 14% and 20% greater than for prescribable nicotine replacement therapy alone. 

Quitting smoking by vaping may be considered uniquely different from quitting using other available methods of nicotine replacement. In addition to replacing nicotine, vaping replaces many of the behavioral, sensory and social aspects of smoking and a culture and language have developed around it through peer to peer contact and support. Because vaping is so different from other types of tobacco cessation support, for those researchers who have engaged with consumers (and unfortunately this is still not common practice), the assistance offered has been especially valuable.

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