Lisa Mueller
Associate Advisor
Smoking cessation is one of the new Westminster government’s top priorities as part of their effort to improve preventative health measures across the UK.
Encouraging smokers to switch to e-cigarettes is an important part of this plan as they’re a lot less harmful than tobacco smoking.
In Great Britain over the last five years, close to three million smokers have successfully quit by switching and the ground-breaking ‘Swap to Stop’ pilot aims to provide a million more with e-cigarettes as a substitute for tobacco.
But while vaping is considered a lower risk it’s not risk free. Though the harms are still not fully understood, it’s expected that ex-smokers will eventually need help to quit vaping too, and that’s in part why the UK government has announced new plans to crack down on youth vaping as part of the recent Tobacco and Vapes Bill.
Understanding people’s differing motivations and perceptions around smoking and vaping is essential to creating interventions that might help them quit. Whilst there’s been plenty of research on smokers’ behaviour over the years, there’s still a lot of work to do to understand perceptions and motivations around vaping, especially relative to cigarette smoking.
Using our online trial platform Predictiv, we surveyed just over 3000 adults in Wales on a range of health questions including how much they smoked and/or vaped, how harmful they thought vaping was and what might motivate them to quit, building on our previous work looking at UK-wide beliefs about smoking and vaping.
What we found
Just over a quarter of respondents said they currently either smoke or vape in some form, broadly in line with national patterns: 9% smoked, 11% vaped and 7% did both.
Similar to our UK-wide findings, just under 3 in 4 of our Welsh respondents incorrectly thought that vapes were as harmful or more harmful than cigarettes. These misperceptions are consistent with the trends reported in Action on Smoking and Health’s (ASH) annual survey.
Given the similarity of harm perceptions in Wales and the rest of the UK, and only small differences in prevalence of smoking and vaping, we can assume that the motivations to quit in our Welsh sample give us some insight into UK-wide quit motivations.
When we asked people who intended to quit smoking or vaping why they gave us a wide range of answers, and usually more than one. The results show that, although smokers and vapers clearly share some concerns, there are also some notable differences.
As shown below, for smokers the top three motivations to quit were money, fitness and being free from addiction. For vapers, both money and being free of addiction, followed by concerns about long-term health conditions and negative effects on their health were the most mentioned motivations.
[Sample size of 465: 275 smokers, 288 vapers, 98 dual users]
What do our findings tell us?
Perceptions about relative harms of smoking and vaping need to be addressed: our research confirms what we and other organisations (including ASH) have found previously – there are some serious misconceptions about the relative harms of vaping among both the general public and current smokers in particular, which may undermine cessation interventions.
Our recent experiment on harm perception showed that even short positive stories about vaping can improve smokers’ harm perceptions. This gives hope that a well-targeted campaign using trusted messengers, such as GPs or friends, could help more smokers quit by switching to e-cigarettes.
Leveraging financial motivations: saving money is the top motivator to quit among both smokers and vapers. This is unsurprising, given the significant cost of both habits and similar findings when we looked into people’s motivations to reduce their alcohol consumption.
Interventions and campaigns to help people quit smoking could be optimised by a greater focus on the financial benefits. For instance, the NHS Quit Smoking app leverages people’s financial motivations by showing how much money a person saves each day by not smoking.
But there’s a further opportunity here: since vaping is a much cheaper habit than smoking, campaigns aimed at helping smokers quit could highlight the financial savings smokers can make by switching to vapes as a stepping stone to quitting completely.
This could, for instance, be incorporated into existing ‘savings calculators’ in ‘quitting’ apps. For example, the NHS Quit Smoking app highlights financial benefits.
Reducing the addictive potential of vapes: both smokers and vapers are motivated to quit in order to free themselves of addictive behaviours. This might make it less appealing for smokers to switch to vaping because they might see it as swapping one addiction for another.
To remedy this, there might be an opportunity for the development of vaping products that reduce nicotine levels automatically over time. 30% of vapers recently surveyed are already reducing their nicotine intakes by choosing e-liquids with lower nicotine content since they started vaping. However, manually reducing the nicotine level requires a certain level of motivation and cognitive load. A vaping product that automates this process, e.g. through vaping technology or an e-liquid subscription service that provides lower nicotine e-liquids every month, could reduce the level of friction and make it easier to beat addiction. This would, however, need to be carefully tested with vapers to see whether it might lead to unintended consequences, such as returning to traditional cigarettes or vaping more to compensate for the lower nicotine dose.
Emphasising health risks (or not): given the immense health risks of smoking, it makes sense to continue to highlight these risks in smoking cessation campaigns.
At the same time however, 50% of smokers in our sample were not motivated to quit for their health. This means some smoking cessation efforts might benefit from highlighting more immediate consequences of smoking, such as financial costs, addiction or reduced fitness.
Although fitness concerns are ultimately linked to longer-term health outcomes, stressing how smoking impacts the ability to be physically active in the here and now could leverage present bias and make the impact of smoking more tangible. Fitness-focused quit messages could target gym-goers, runners and other athletes with messages like: “Want to beat your personal best? Quit smoking!”.
Looking ahead, the findings from our experiment point to several promising directions for future work in smoking cessation, particularly from a behavioural science perspective. There is a clear need to develop interventions that address the complex interplay between smoking behaviours, harm perceptions and motivations. As the landscape of smoking and vaping continues to evolve, ongoing research and innovation in this field will be essential in supporting individuals on their journey to a smoke-free life.
If you want to discuss these findings or partner with us to reduce smoking rates, then please contact us.
