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A new report from the United Kingdom’s top public health agency warns that misinformation about the risks of e-cigarettes is deterring smokers from switching to vaping.

Public Health England’s (PHE) sixth independent report on e-cigarettes, released yesterday, shows more than half of U.K. smokers believe e-cigarettes are just as or more harmful than combustible cigarettes. The proportion of smokers who correctly believe e-cigarettes are safer than combustible cigarettes stands at less than a third.

“Safety fears may well be deterring many smokers from switching, leaving them on a path to years of ill health and an early death due to their smoking,” said John Newton, director of health improvement at PHE.

The report’s findings are especially disturbing because U.K. public health experts have, for years, issued advice urging smokers to switch to e-cigarettes. PHE has been outspoken in emphasizing the benefits of switching to e-cigarettes, compared to U.S. public health groups.

PHE assigns much of the blame for increased risk perception to last year’s outbreak of vaping-related lung illnesses in the United States. U.K. health authorities were quick to recognize these illnesses were attributable, not to legal nicotine vapes, but to black-market THC products that were cut with vitamin E acetate. After months of investigation, the Centers for Disease Control and Prevention (CDC) finally concluded what many health experts had been saying from the start— the principal-agent of harm causing vaping-related illnesses. was not nicotine but vitamin E acetate.

“The mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among U.K. smokers following the U.S. lung injury outbreak in autumn 2019,” says the PHE press release. “U.S. authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping products, was a primary cause of the U.S. outbreak. This substance is banned from U.K.-regulated nicotine vaping products.”

The widespread misperception about the risks of e-cigarettes in the U.K. mirrors patterns in the United States. A Morning Consult poll released in February, for example, showed that just 28 percent of adults correctly believed THC products were responsible for the lung illnesses associated with vaping.

The proportion of Americans mistakenly believing vaping nicotine is just as dangerous as smoking has been rising for several years, no doubt, at least in part, as a result of years of largely uncritical media coverage given to poorly conducted studies lacking sufficient context about the relative risks of e-cigarettes.

For much of the past decade, one of the most prolific anti-vaping researchers, Professor Stanton Glantz of the University of California—San Francisco (UCSF), was frequently cited by prominent media outlets as an expert on e-cigarettes. However, the Journal of the American Heart Association (JAHA) recently retracted one of Glantz’s papers claiming e-cigarettes can double the risk of heart attacks for being unreliable.

Many politicians and journalists continue to assert that e-cigarette flavors are the principal reason for the rise of youth vaping. But as recently as December, the CDC published research showing more than 75 percent of young people who vape cite things other than flavors as the reasons they use e-cigarettes. Additionally, there has been no substantial rise in youth vaping in the U.K., where flavors are widely available and new nicotine products can enter the market with relative ease.

The PHE report also warned that e-cigarette flavor bans, such as those being pursued by many state governments and partially implemented at the federal level, could deter smokers from switching to e-cigarettes. Smoking remains the leading cause of preventable death in the United States. Unfortunately, a toxic combination of federal regulation, state legislation, and public misperception is threatening to destroy the e-cigarette industry. These regulations and bans could end up denying millions of adults access to e-cigarettes, which have been proven to be a substantially safer alternative to cigarettes.