In the last few weeks, numerous sources have suggested vaping could be a risk factor for either contracting or increasing the severity of COVID-19. These reports are almost entirely based on the speculation from anti-vaping advocates, who rarely receive significant pushback, writes Guy Bentley, director of Consumer Freedom for the Reason Foundation.
Appearing on NBC’s Today Show on March 23, U.S. Surgeon General Jerome Adams postulated, without evidence, that vaping could be the reason young people may be at higher risk from COVID-19 than previously thought. “There are theories that it could be because we know we have a higher proportion of people in the United States and also in Italy who vape,” said Adams.
But [on April 16] the U.S. Food and Drug Administration (FDA) told Bloomberg News, “E-cigarette use can expose the lungs to toxic chemicals, but whether those exposures increase the risk of COVID-19 is not known.”
While seemingly anodyne, the statement differs significantly from those of Nora Volkow, director of the National Institute on Drug Abuse (NIDA). Volkow, recently wrote in the Annals of Internal Medicine that vapers could be at high risk for coronavirus.
Similarly, last week, Massachusetts Attorney General Maura Healey went so far to issue an advisory warning that vaping could worsen the spread of COVID-19. And last month, New York City Mayor Bill de Blasio claimed, “If you are a smoker or a vaper that does make you more vulnerable.”
Following an apparently unclear email exchange with an FDA official, Bloomberg News published a story with the headline: “Vaping Could Compound Health Risks Tied to Virus, FDA Says,” that prompted Iowa Attorney General Tom Miller and 12 public health experts to write to the FDA to complain. The signatories warned the FDA that if its communications are “arbitrary and ill-conceived, spreading fear and confusion with little scientific basis and unpredictable consequences, then it would be better if the FDA and its media spokespeople did not comment further at this time.”
Thankfully, the FDA finally appears to be taking this advice seriously. There is currently no evidence from anywhere in the world showing vapers to be at higher risk for COVID-19, Bentley writes in his editorial.
The Science Media Research Center recently released statements from public health experts to help reporters understand what we do know about smoking, vaping, and COVID-19. “There is no evidence that vaping increases the risk of infection or progression to severe conditions of COVID-19,” said Dr. Caitlin Notley. She added that since switching from smoking to vaping improves cardiovascular and respiratory conditions, smokers who switch “might be expected to have a better prognosis if infected by COVID-19.”
Similar to last year’s outbreak of lung illnesses that were initially wrongly associated with conventional e-cigarettes, but later found to be the result of adulterated black market marijuana products, much of the communication around vaping and COVID-19 is targeted at young people in an effort to get them to stop vaping.
The Campaign for Tobacco Free-Kids (CTFK) and Parents Against Vaping Electronic Cigarettes (PAVE) has consistently promoted stories linking vaping and the coronavirus. On April 15, for example, they even promoted a campaign to tell the White House that vape shops are not essential businesses.
“There is growing concern among public health experts that e-cigarettes can put users at greater risk for serious complications from COVID-19, these products are addicting our kids, and they have not been proven to help smokers quit,” says CTFK.
The statement is disingenuous. E-cigarettes have been proven beyond any reasonable doubt to be far safer than combustible cigarettes and consistently shown to help smokers quit. Italy, Spain, France, and Switzerland are keeping their vape shops open because they recognize the public health benefit of ensuring access to safer alternatives to cigarettes.
It’s time for anti-vaping groups to stick to the facts and stop spreading fear and misinformation about a product that is saving millions of lives both in the U.S. and across the globe. Stopping kids from vaping is undoubtedly a noble goal, but it’s not an excuse for misleading the public in ways that could prevent smokers from switching to a dramatically safer product.
‘Bear bites man’ is a news story, of course, but ‘man bites bear’ is sure to make page one.
By George Gay
Look out! There’s a brown, big bear in that tree!
No, don’t concern yourself, there’s no bear; I was just making a point. No English speaker would utter that warning. What they would say is: Look out! There’s a big, brown bear in that tree!
If you string adjectives together in English, they follow a certain order in which, for instance, size—big—comes before color—brown—and, for that matter, age—old—comes before shape—fat—and both age and shape come between size and color. I don’t know what the order is off the top of my head, so I had to look it up to describe the examples above, but I, like others, use the correct order instinctively almost all the time.
The question is, does the order really matter? Well, from a practical point of view, perhaps.
After all, you wouldn’t want Joe, the person being warned, to get into a semantic argument about whether it was right to say the bear was brown and big or big and brown because, in the meantime, the bear might have come down from the tree and the arguments would turn to whether the animal in question could be described as an angry, big, brown bear, a big, angry brown bear or any of the other adjectival combinations available—and, finally, whether it was creating a big, bloody mess of Joe, or a bloody big mess.
On the other hand, languages evolve, and if it weren’t the case that the human race was going to be wiped out within the next 100 years by the effects of environmental breakdown, it’s not hard to imagine that, many years into the future, the creature in the tree might have become known by English speakers as a brown, big bear or, in a really progressive society, referred to according to a description chosen by bears or their democratically elected representatives.
Already, there is a tendency to flexibility—I would say laxity—over word order, especially when it comes to story headings. Take this one from insidesource.com: “Public health’s misinformation against vaping is eroding its credibility.”
The way that I read this heading is by assuming that “its” refers to vaping because “its” is closer to vaping than it is to the other referential candidate, “public health,” so that what I assume is being said is that the credibility of vaping—as a means of quitting smoking—is being undermined by the misinformation put out under the name of public health.
Credit: Desdemona72
There is truth in this because such misinformation does get through to some smokers. But, when you read the story, it turns out that what is being said is that public health is undermining its own credibility by putting out misinformation about vaping.
Again, the question arises as to whether this confusion matters. I would say yes because I, and perhaps others, would be likely to skip over a story that was about vaping being undermined by public health misinformation because that happens all the time.
I would be much more likely, however, to read a story about the credibility of public health being undermined because such stories are rarer. “Bear bites man” is a story, of course, but “man bites bear” makes page one.
Finally, the point is that the heading could be fixed easily as “Public Health’s credibility eroded by its issuing misinformation on vaping.”
Credibility aside, I shouldn’t think that public health would have been overjoyed to see the following headline from eatthis.com: “Vaping versus smoking marijuana: Which is better for your body?” I cannot help thinking that public health would have found this heading unnecessarily provocative.
Given that both activities carry a level of risk, the question that public health would probably have preferred is “Vaping versus smoking marijuana: Which is worse for your body?” And this is not withstanding that these activities are seen by many people as having some positive outcomes.
This is an interesting heading, however. When I first read it, I thought the physical effects of vaping nicotine were being compared with those of smoking marijuana. It took me a while to work out that it was vaping marijuana and smoking marijuana that were being faced off.
My initial interpretation of the heading might have been perverse, but I think what was written could have been made clearer as “Which is better for your body, vaping marijuana or smoking it?”
While I usually ignore stories whose headings pose questions because I feel that I am going to be asked to do the story’s heavy lifting, this particular heading is intriguing. In fact, I would have read the whole story had I been a little cleverer and been able to activate the link from the synopsis that I saw.
One thing that intrigues me is why the headline writer didn’t pose the more general question: “Vaping versus smoking marijuana: Which is better for you?” And why, if she felt she wanted to be more specific, did she go for the body? Why not the mind? “Which is better for your mind?”
Credit: andriano_cz
Perhaps some would even have preferred the focus to have been on the soul. I don’t think there is a clue in the “eat this” name because in both cases we’re talking about inhalation. I guess I’ll never know.
The next heading I would like to look at is from thedrum.com and is perfectly clear as I read it: “Chinese vaping brand accused of flouting advertising rules designed to protect children.” It is clear, but it is misleading in an important way. Compare this heading: “Cudgel accused of breaking man’s skull in vicious daytime attack.”
Most people would laugh at such a heading, saying that you cannot accuse a cudgel of doing anything; the accusation must be aimed at the person wielding the cudgel. But by the same token, those people would probably not think twice about an accusation being leveled at a vaping brand, an equally ridiculous idea in my view. In fact, it is possibly more ridiculous.
It is conceivable that a cudgel could be made to stand in the dock and eventually be sent to prison as nonhuman animals have been in the past. But a brand does not have a bodily form.
The question is, as always, does any of this matter? I would say yes. Leveling the accusation at the brand lets off the hook those who allegedly caused the rules to be flouted.
What is likely to happen if the allegations are substantiated is that the company that owns the brand name will be fined, a fine that will possibly be recouped through increasing the price customers pay for the product. The person or people who allegedly caused the laws to be flouted will be unaffected and therefore free to repeat the offense either at the same company or at a new one.
I have written previously about the dangers of anthropomorphism, which crops up in such phrases as “vaping brand accused” and, of course, “the market panicked.” But having said that, I have to admit that it is almost impossible to avoid such anthropomorphism at times as observant readers and pedants will have noticed from a couple of stories above where “public health” is said to be up to all sorts of things that, in fact, only people working in public health can do.
The problem is that trying to insert phrases such as “people working in public health” every time becomes clumsy and, frankly, unnecessary. And, of course, there are instances where this sort of thing simply doesn’t matter. I recently saw an advertisement for “meditation for businesses.” But beware when it is said that a business was found to have been involved in money laundering.
Perhaps one problem with headings is that they are thrown together at the last moment and can thus carelessly undermine what might be an article that is worth reading. I noticed this heading in thejournal.ie: “Opinion: E-cigarettes are not part of the solution to a tobacco-free Ireland.”
This seems blindingly obvious to me. The solution to a tobacco-free Ireland must surely be the introduction of tobacco in the same way that the solution to an alcohol-free Ireland would be the introduction of alcohol.
The problem here, I think, is the word “solution,” which has been allowed to slosh about all over the place in recent years, and here is clearly adrift. I guess the heading should have read something like: “Opinion: E-cigarettes will not help solve Ireland’s tobacco smoking problem.”
I must admit that, initially, I was drawn to the following heading on nst.com.my because GEG are my initials: “Two million will die if GEG bill not passed.” Nevertheless, what I really like about this heading is that, without even knowing what GEG stands for, you know that the heading is correct, and, what’s more, you know even that its negation is correct.
So, the headline writer could have written: “Two million will die if GEG bill passed.” This is because people have finite lives. The 2 million people in question will die. That’s a certainty. What I suppose the headline writer must be getting at is that 2 million people will die prematurely if the bill is not passed. But, to my way of thinking, “dying prematurely” is one of those odd concepts that seems nevertheless to be universally accepted. Surely, it’s just a case of when your number’s up, it’s up.
If you quit smoking and, on your first smoke-free day, you don’t stop at the tobacconist, you might get hit and killed by a driver jumping the lights at the intersection, something you would have avoided by stopping at the store. But, to my mind, you wouldn’t have died prematurely even then.
In any case, from the synopsis of the story, it seems as though the emphasis wasn’t on “saving lives;” it was about saving money. Tax revenues from sales of cigarettes weren’t covering the costs of treating smoking-related diseases. A cynical person might be forgiven for reaching the conclusion that the smokers were seen not to be dying “prematurely enough.”
Credit: Alswart
And you can look at this another way. By giving up smoking and living a little longer, those 2 million people will have a greater negative impact on the environment than if they had died earlier and therefore might be responsible for the earlier deaths of others. Life and death are not simple matters.
Now, I would like to draw attention to a heading at colinmendelsohn.com.au: “New Campaign Outlines the Real Truth About Vaping.”
Colin Mendelsohn is one of those brave souls who has for a long time been trying to inject some rational thinking into the debate in Australia about the use of vaping as a means of helping smokers quit their habit—a debate that has been seriously marred by misinformation. I mean, look at the heading. What does it say about us when Mendelsohn feels it necessary to include the word “real” before the word “truth”?
OK, this heading from The Herald is way beyond the usual range of stories for a vape-focused magazine, but I just cannot resist it: “Zimbabwe: Tobacco farmers earn $7 million in three days.” At one and the same time, this heading, reporting on April 5 on the first three days of leaf tobacco sales for the 2021–2022 season, is true but manages to grossly understate the work of tobacco growers and imply, incorrectly, that these growers were enjoying some sort of bonanza.
The first thing to note is that these growers are not people playing the financial markets; they don’t earn that sort of money in three days. The second thing to note is that, in fact, they worked a lot longer than three days just to earn a modest amount of money. And I mean modest.
Tobacco growers work long days, mostly out in the open, during a long, worry-filled season that can be upset by a whole range of often uncontrollable factors, including plant diseases, unhelpful weather and unscrupulous middle operators. And what do they get at the end of it?
Well, according to The Star newspaper, reporting more or less at the end of the sales season, growers received an average of about $3.05 per kilogram for their tobacco, a figure that was up 9.3 percent on the $2.79 per kilogram they received the previous season.
This sounds like a good payday, except that the $3.05 per kilogram of this year was up only 3.7 percent on what they earned in 1996—$2.94 per kilogram. You’re reading that correctly, 1996—more than a quarter of a century ago. The 2022 average price was actually lower than it was in 2008, 2012, 2013 and 2014.
An FDA-funded study falsely claims that e-cigarette use negatively impacts health and increases utilization and cost.
By VV staff
Misinformation is incorrect or misleading information. It is different from disinformation, which is deliberately deceptive. Both are rampant in the vaping industry; however, it is difficult to distinguish between them.
Complicating the issue, it’s impossible to tell if researchers of disproven or flawed anti-vaping studies conducted defective studies intentionally or if they were just bad at their jobs. Many vapor industry advocates claim researchers are intentionally coming to conclusions that fit the U.S. Food and Drug Administration’s “supposed goal” of eventually banning all nicotine products, especially when the studies are being funded by the FDA.
In one recent study, researchers found that the use of electronic cigarettes costs the United States $15 billion annually in healthcare expenditures—more than $2,000 per person a year. The study, published on May 23 in Tobacco Control, is the first to look at the healthcare costs of e-cigarette use among adults aged 18 and older, according to researchers at the University of California San Francisco School of Nursing.
“Our finding indicates that healthcare expenditures for a person who uses e-cigarettes are $2,024 more per year than for a person who doesn’t use any tobacco products,” said lead author Yingning Wang of the University of California San Francisco Institute for Health and Aging.
According to the U.S. Centers for Disease Control and Prevention, combustible cigarette smoking-related illness in the United States costs more than $300 billion each year, including more than $225 billion for direct medical care for adults. With an estimated 30 million smokers, that is $10,000 a year more than for a person a who doesn’t use tobacco products.
The researchers based their estimates of healthcare costs and utilization on data from the 2015–2018 National Health Interview Survey. Healthcare utilization included nights in the hospital, emergency room visits, doctor visits and home visits. “Healthcare costs attributable to e-cigarette use are already greater than our estimates of healthcare costs attributable to cigar and smokeless tobacco use,” said Wang. “This is a concerning finding given that e-cigarettes are a relatively new product whose impact is likely to increase over time.”
The results of the study appear to be based on two key assumptions, according to Jamie Brown, professor of behavioral science and health and director of the Tobacco and Alcohol Research Group at University College London.
“First, that the identified associations between e-cigarette use and poor health status are caused by e-cigarettes. The majority of people who use e-cigarettes are also former or current cigarette smokers. Despite the attempts at adjustment, it is likely that at least some of the association is actually caused by cigarettes,” said Brown. “The second assumption appears to be that the alternative is simply that these people would not be using e-cigarettes. However, we know that e-cigarettes help people to quit smoking cigarettes and that cigarette smoking causes enormous healthcare expenditure. Therefore, the key question is: What is the net impact on healthcare utilization when trying to account for how e-cigarettes affect how many people smoke cigarettes? These types of models have tended to suggest net benefits are likely.”
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Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University of London, called the study a “baffling” piece of work. “The authors report that people who use e-cigarettes have poorer health and incur higher health costs than nonsmokers, but it is not clear why they assume that the excess health expenditure incurred by smokers who are trying to limit their smoking by using e-cigarettes—often because of acute health problems—is caused by their recent vaping rather than by their lifetime smoking,” said Hajek. “This is like claiming that the extra health expenditure incurred by people with broken legs is caused by using crutches.”
Researchers for the study sought to put a price tag on the health costs of e-cigarette use, certainly a reasonable component in the policy trade-offs over the use of e-cigarettes, according to Chuck Dinerstein, director of medicine at the American Council on Science and Health (ACSH), who has over 25 years of experience as a vascular surgeon.
He stated that in order to get their data, researchers developed a model using the National Health Interview Survey (NHIS), a household survey of the general population in the U.S. that includes detailed questions on health and use of tobacco products. “The researchers point to a study using NHIS data that per smoker—meaning combustible—attributable healthcare expenditures are $5,602,” explained Dinerstein. “The finding of this study, for both those exclusively using e-cigarettes and the dual users, is roughly a third as much. E-cigarettes reduce healthcare utilization and costs.
“The researchers point out that exclusive e-cigarette users had ‘higher odds of reporting poor health status than never tobacco users.’ That would be no surprise; no one is claiming e-cigarettes do no harm; they are less harmful than the alternative. Just like the prescription of buprenorphine is less harmful than the free-market acquisition of fentanyl … E-cigarettes have been marketed for 15 years and have been the tobacco product of choice for young adults for eight years. I find the assumption that e-cigarettes alone have manifested increased health costs at this point debatable.”
Cameron English, director of bio-sciences at ACSH, believes that the study had several critical flaws, with the most serious being the assumption that e-cigarette use would negatively impact an individual’s health and that this negative impact would increase utilization and cost. “The authors assumed what they should have demonstrated,” stated English. “That’s especially troublesome because existing evidence suggests that vaping is far less harmful than smoking. Instead of boosting healthcare expenditures, e-cigarette use probably reduces the amount of money spent to treat sick smokers. In sum, the Tobacco Control paper is terrible.”
While the research itself is scientifically suspect, two other troubling details should also be highlighted, according to English. “First, FDA paid for this low-quality study—then publicly denied any involvement until the paper was published. Second, the agency’s actions appear to reflect a broader effort to shape the peer-reviewed vaping literature then use it to justify excessive e-cigarette regulations.”
It should also be noted that while the FDA’s primary concern is saving youth from the dangers of vaping, researchers in the FDA-funded study’s opening cite concerns about the increased use of e-cigarettes by youth, especially those aged 15 to 24. “The Truth Initiative, an anti-smoking group funded by money from the Tobacco Settlement, reports that those [aged] 15 to 17 are ‘16 times more likely to vape than people aged 25 to 34,’” explains English. “Among the limitations of the study, the researchers indicate that the young, those we should be most concerned about, were not included in the study. ‘We did not include youth in the analysis due to their low healthcare utilization,’ [the researchers said].”
EVALI caused chaos
Whether it’s misinformation or disinformation, it’s costing lives. It’s keeping combustible cigarette smokers from switching to less harmful products. Another recent study led by researchers at the American Cancer Society shows that perceptions of e-cigarettes as being “more harmful” than cigarettes by adults in the United States more than doubled between 2019 and 2020, and perceptions of e-cigarettes as “less harmful” declined between 2018 and 2020.
Credit: andriano_cz.
The study also found that an increase in cigarette smoking prevalence (2019–2020) was restricted to those who perceived e-cigarettes as “more harmful” than cigarettes while increases in prevalence of e-cigarette use were restricted to those who perceived e-cigarettes as “less harmful” than cigarettes, according to a press release.
Prevalence of dual use of both products increased only among those who perceived these products “as harmful.” The results coincide with the e-cigarette or vaping use-associated lung injury outbreak (EVALI) and the Covid-19 pandemic. The data was published in the American Journal of Preventive Medicine.
“While all tobacco products, including e-cigarettes, pose a risk to the health of the user, major health events, such as the EVALI epidemic in late 2019 and the Covid-19 pandemic in 2020, paved the way to new smoking/e-cigarette health risks,” the release states. “During this time, the quality and type of information individuals were exposed to may have shaped how they compare the potential harms of tobacco products, which, in turn, may have altered tobacco use behaviors.”
How individuals perceive the harm of e-cigarettes versus traditional cigarettes can predict their individual decision to use tobacco products, but according to the study authors, this is the first study to provide evidence that this relationship translates to population-based prevalence changes.
“While this study showed sharp changes in public perceptions of e-cigarette versus cigarette harms during EVALI and Covid-19, the more relevant finding for public health is that increases in cigarette smoking and e-cigarette use prevalence occurred primarily in individuals who perceived their preferred product as relatively less harmful,” said Priti Bandi, principal scientist of risk factors and screening surveillance research at the American Cancer Society and lead author of the study. “This suggests that public perceptions of e-cigarette versus cigarette harms influence population tobacco use patterns.”
In this study, researchers analyzed data from the National Cancer Institute-sponsored Health Information National Trends Survey collected from more than 10,000 U.S. adults from 2018 to 2020. The results showed that perceptions of e-cigarettes as “more harmful” than cigarettes doubled each year, increasing most between 2019 and 2020 (2018: 6.8 percent; 2019: 12.8 percent; 2020: 28.3 percent) while uncertainty (responses of “don’t know”) in relative harm declined (2018: 38.2 percent; 2019: 34.2 percent; 2020: 24.7 percent).
“Less harmful” relative perceptions declined (2018: 17.6 percent; 2019: 15.3 percent; 2020: 11.4 percent) while “as harmful” perceptions remained steady (2018: 37.4 percent; 2019: 37.7 percent; 2020: 35.6 percent). Exclusive cigarette smoking increased between 2019 and 2020 among those who perceived e-cigarettes as relatively “more harmful”(2018: 18.5 percent; 2019: 8.4 percent; 2020: 16.3 percent), exclusive e-cigarette use increased linearly among those who perceived them as relatively “less harmful” (2018: 7.9 percent; 2019: 15.3 percent; 2020: 26.7 percent), and dual use increased linearly in those who perceived them “as harmful”(2018: 0.1 percent; 2019: 1.4 percent; 2020: 2.9 percent).
“It is challenging for individuals to make conclusions about the short[-term] and long-term health effects of tobacco products without clear, effective and ongoing communication from public health authorities, especially when new contextual events that change health harms happen,” said Bandi in a statement. “There is a need for behavioral interventions to encourage individuals to be informed consumers of available scientific findings and appreciate that while no tobacco product is safe, there are inherent differences between relative and absolute harms between tobacco products that can influence behavior. In turn, public health education campaigns must facilitate informed decision-making by translating emerging scientific evidence accurately to appropriate audiences.”
Many people also mistakenly believe that the most dangerous thing about smoking is nicotine. Many falsely believe that nicotine causes cancer. “When people who smoke perceive nicotine-replacement therapy or nicotine vapor products to be as harmful or more harmful than smoking, they are less likely to use less harmful products when attempting to quit smoking,” says Kim Murray, a research fellow with the Taxpayers Protection Alliance.
Murray believes that the widespread misperception about nicotine is due to misinformation. The misinformation is rampant in media and government messaging. This can have damaging impacts on public health.
Credit: Wachiwit
“Unfortunately, the number of people believing the misinformation about nicotine vapor products is rising,” she wrote in an opinion piece. “One of the biggest sources of misinformation is fake news shared on social media. There is a real need for informative and accurate information about smoking and nicotine, but most people don’t know where to find the information,” states Murray. “A logical resource should be their healthcare provider. However, most of the time, that would be the wrong choice because 60 percent of nurses incorrectly perceive nicotine as carcinogenic, and 72 percent believe that nicotine patches could cause heart attacks.”
In April, researchers concluded that more than 60 percent of all doctors incorrectly believe all tobacco products are equally harmful, making them less likely to recommend e-cigarettes for people trying to quit smoking, according to a study published in JAMA Network Open.
The authors of the study, led by Rutgers University, asked more than 2,000 doctors in the U.S. in 2018 and 2019 how they would advise patients on using e-cigarettes as a method of combustible smoking cessation. One in four physicians discouraged all use of e-cigarettes and were more likely to advise against e-cigarettes if the hypothetical smoker they were counseling were a younger, light smoker compared to an older, heavy smoker.
Although no associations were found between harm reduction beliefs and being asked about e-cigarettes by patients, the association between physicians’ harm reduction beliefs and their e-cigarette recommendation practices was significant.
“It will take a lot to change minds and dispel the now entrenched, and largely mistaken, mistrust of nicotine. As in many areas of public life, urban myths and half-truths, which are ingrained over time, are often easier to believe than the truth for many in society. It is difficult to persuade people that the beliefs that they hold are wrong,” states Murray. “Consumers deserve accurate information to enable them to make informed choices. The country won’t achieve health equity and social justice if we continue to misinform those who choose to use nicotine in a safe manner.”
This article first appeared in Vapor Voice 3, 2022.
A claim in the British Dental Journal that found vaping to cause tooth damage was made by two food science lecturers at the Cardiff Metropolitan University School of Sport and Health Science. That study has now been shown to be rife with errors.
A letter has since been published in the British Dental Journal by Newcastle University vaping and dentistry experts Richard Holliday, Elaine McColl, Anthony Weke and Zella Sayeed debunking the claims out of Cardiff.
The four wrote they “were disappointed to see several basic errors and misrepresentations” and went onto correct five major errors in the “erosive potential of vaping” paper.
Newcastle’s experts say the study authors cite a World Health Organization poster and incorrectly claim that nicotine causes a “high risk of oral and whole-body health complications.”
In reality, nicotine has been used in the form of NRT for over 30 years, including in pregnant women, and is regarded as extremely safe, even for long-term use, according to Scoop.
Also significantly, the authors wrongly claim that e-cigarettes are associated with cancer. The supporting reference does not make this claim and instead states “no long-term evidence related to oral and systemic health effects exist.”
The Newcastle experts then “point UK dental professionals to the well-considered public health guidance which basically concludes that, for the best chances of quitting smoking, one should use support and pharmacotherapy and that e-cigarettes can be part of that package.”
Nancy Loucas, executive coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), said the food science lecturers’ biggest mistake was “one made by so many – that is talking up the WHO’s anti-vaping stance” as the official public health position.
“Tellingly, all UK public bodies, including the NHS, ignore the WHO’s advice. They support vaping, knowing it does not erode teeth nor lead to gum disease,” said Loucas. “Once again science and human evidence have trumped another untenable ideological lie about vaping.”
More than 60% of all doctors incorrectly believe all tobacco products are equally harmful, making them less likely to recommend e-cigarettes for people trying to quit smoking, according to a study published in JAMA Network Open.
The study, led by Rutgers University, shows that researchers asked more than 2,000 doctors in the U.S. in 2018 and 2019 about how they would advise patients on using e-cigarettes ask a method of combustible smoking cessation. One in four physicians discouraged all use of e-cigarettes and also were more likely to advise against them if the hypothetical smoker they were counseling were a younger, light smoker compared to an older, heavy smoker.
Credit: Airdone
Although no associations were found between harm-reduction beliefs and being asked about e-cigarettes by patients, the association between physicians’ harm-reduction beliefs and their e-cigarette recommendation practices was significant.
“These findings show it is critical to address physicians’ misperceptions and educate them on e-cigarettes’ efficacy, particularly correcting their misperceptions that all tobacco products are equally harmful, as opposed to the fact that combusted tobacco is by far the most dangerous,” lead author Cristine Delnevo, the director of the Rutgers Center for Tobacco Studies, said in a statement.
The belief that all tobacco products are equally harmful was associated with lower rates of recommending e-cigarettes, the study states, adding that as the evidence base grows for e-cigarette efficacy for smoking cessation, there is need for physician education regarding e-cigarette efficacy.
“As the evidence base grows for e-cigarette efficacy for smoking cessation, physicians’ understanding of e-cigarettes in the context of harm reduction must keep pace with the emerging scientific evidence through effective educational opportunities,” the study’s authors write. “Such opportunities should address e-cigarette safety and efficacy and correct misperceptions that all tobacco products are equally harmful.”
There may be no industry with more misinformation than vaping. The American Council on Science and Health (ACSH) today published a list of many of the vaping and e-cigarette related studies that involved “junk science.”
Credit: Kraken Images
“The media reports the results of sloppy vaping research, then quickly forgets them. We do not,” writes Cameron English for the pro-industry advocacy organization founded in 1978. “What follows is a list of many of the low-quality studies that have investigated the alleged health risks of e-cigarette use. We’ll regularly update this catalog of bad studies as necessary.”
“The past year has seen the publication of many studies alleging that e-cigarette use (vaping) carries very serious health consequences, everything from depression to erectile dysfunction and higher stroke risk,” English writes. “Each paper generated widespread media coverage, usually one news outlet duplicating the uncritical coverage of the last, giving consumers the false impression that vaping poses a greater health threat than it actually does. When we examined these studies in more detail, we identified their serious flaws and reported them to our readers.”
English also suggests that health reporters tend to obsess over a topic for a few days then forget it entirely, quickly moving on to the next exaggerated study. This means the public often only hears the information relayed from the faulty study and is never informed that the information isn’t sound.
The official website for the U.S. Army yesterday published an article wrongly blaming EVALI on nicotine vaping products. The article states that “vaping has been commercially available since the early 2000s, and there have been hundreds of reports” of EVALI since then. “Public Health officials advise against the use of e-cigarettes, but highly recommend purchase from known vendors, if consuming … Washington says an estimated 200,000–300,000 active duty service members are diagnosed with acute respiratory issues annually.”
After the CDC announced that vitamin E acetate in black market marijuana vaping products was the cause EVALI more than two years ago, many media outlets continue to falsely blame nicotine vaping products for the lung illness that was first identified in 2019.
Credit: Master1305
A study published in January 2020 in the journal Toxics provided important insight into the lung intoxication epidemic. The study presented, for the first time, a comprehensive analysis of products used by EVALI patients. Vitamin E acetate was the main finding in cannabinoid liquids. No compound that could be linked to EVALI was found in the two nicotine products tested.
Some tobacco control experts said the CDC created panic with its refusal to directly blame the actual causes of EVALI, vitamin E acetate in illegal THC vapes. Following CDC’s lead, state health departments spread the word that using an e-cigarette to quit smoking could be life-threatening — so much so that seven states issued emergency bans on the sale of most or all electronic cigarettes.
“Throughout its investigation of the first outbreak, CDC created public hysteria over the dangers of electronic cigarettes by attributing the outbreak to all vaping products, whether they contained nicotine or THC and whether they were purchased at a highly regulated vape shop or from a drug dealer on the street,” wrote Michael Siegel, a professor in the Department of Community Health Sciences, Boston University School of Public Health, where he has conducted research on tobacco for 25 years, at the time. “The very name that CDC attached to the outbreak directly implicated electronic cigarettes, which are nicotine-delivery devices that are effective in helping adult smokers to quit smoking. Following CDC’s lead, state health departments spread the word that using an e-cigarette to quit smoking could be life-threatening — so much so that seven states issued emergency bans on the sale of most or all electronic cigarettes.”
Respira Technologies is likely using a website to spread misinformation about vaping in order to promote its own product. Jim McDonald of Vaping360 reports that a website promoted by Respira contains false allegations that a scientist commissioned by Public Health England (PHE) and an author of the “vaping is 95 percent safer” than combustible cigarettes study had financial ties to the tobacco industry.
The California-based company with plans to pursue drug approval for an inhaled nebulizer-style nicotine replacement therapy product has also engaged in a smear campaign suggesting Juul Labs and other vaping product manufacturers may be responsible for causing some of the “EVALI” lung injury cases, and has encouraged the U.S. Food and Drug Administration to adopt standards that would prevent most consumer vapor products from being authorized for sale, according to McDonald.
Respira links its own website to a site called “Vaping Fact Checker” that attempts to tie nicotine vaping to the 2019 “EVALI” lung injury outbreak. A page on the site titled “EVALI Linked Products” shows Juul, SMOK and Suorin products and implies that they have caused or could cause “EVALI.”
Under the heading “Myth Busting,” the Vaping Fact Checker website also claims that “one of the authors” of Public Health England’s 2015 e-cigarette evidence review has “financial ties” to tobacco company Philip Morris International.
British tobacco harm reduction advocate Clive Bates, who has followed and been part of the debate over the 2015 PHE report, is director of Counterfactual Consulting and a former director of Action on Smoking and Health (ASH) in the UK, said that it appears the author of the Vaping Fact Checker claim has (either misinformation or disinformation) confused the PHE review with a separate paper authored by a group of experts led by drug researcher David Nutt.
“It is both offensive and preposterous to claim that the experts undertaking Public Health England’s evidence reviews were somehow compromised by tobacco industry interests,” Bates told Vaping360. “They are all scientists of the highest standing with no conflicts of interest.”
Increasing rhetoric and false statements are preventing progress in the debate about vaping.
By Josh Church
A new year and still the same tired rhetoric. With anti-vaping groups being dangerously considered by many as the defenders of public health, we are moving too close to something we have all seen, experienced and been defined by in the history of the United States.
Go back almost 100 years and a shockingly similar story was just being written: In the 1920s and 1930s, a campaign utilized fear and misinformation to push for regulations in favor of those who opposed cannabis and an endless amount of other “narcotics.” The campaign was so extremely effective that it took the better part of a century for public opinion to mature intellectually. It was the age of “reefer madness.”
When you compare the propaganda used by marijuana antagonists during the cannabis prohibition period, it is unmistakably like what we are currently seeing regarding nicotine and the wildfire of misinformation that is taking our country by force. George Santayana explained it best when he said, “Those who cannot learn from history are doomed to repeat it.” Have we not moved past allowing nonfactual propaganda and blatant misinformation to drastically influence our opinions, emotions and, most of all, our decision-making?
It is of the utmost importance that 2019 be a year of defining the conversation among vapor industry stakeholders, advocacy groups and consumers. We must come together and create a platform based on substantiated science with the purpose of educating people inundated by bad science and opinion. It is important that we are passionate but not emotional. It is too easy to discredit information delivered in a way that could be misconstrued as combative. If we accomplish this, we may have an equal, united voice against the anti-vaping and anti-nicotine zealots.
We must realize that there is a very large and discrete change happening on the opposing side. We have moved past the era of people and groups being able to say that e-cigarettes have not been studied for long-term health effects, or that the vapor industry exists unregulated or even that nicotine on its own is largely the cause for tobacco-related diseases. These things are blatantly untrue.
During the U.S. Food and Drug Administration’s (FDA) youth cessation hearing held in January (see “Angle of Attack”), I witnessed a woman from one of these so-called public health groups stand in front of the FDA and make a statement that e-cigarettes have never been proven to help people quit smoking combustible cigarettes and that there are no long-term studies regarding the health effects of e-cigarettes.
It was also upsetting to see the people on both sides of the aisle bringing more emotion and opinion to the table rather than factual evidence. While I wholeheartedly understand the worries and concerns from parents and administrators on the front lines of the youth initiation issue, making unsubstantiated claims benefits no one, especially youth. We are dealing with situations that have absolutely zero room for emotions. The industry and its antagonists can no longer use anecdotal evidence to back their respective opinions.
All parties have been doing this for years, and it has gotten us nowhere. There is no longer an excuse for these types of responses. The research has been done. There are thousands of studies that have been published on e-cigarettes and vaporizers. If you truly feel you are a defender of your right to vape, please take a little time and educate yourself. Review both the good and the bad research.
It does more harm than good when advocates promise friends and family that there is no risk involved with e-cigarettes, telling them that they are 100 percent healthy. It’s not our job to make people believe these products are without their own set of inherent risks. We must educate them with the information that is available. If we do this properly, we can help adult smokers form educated opinions about vapor products, and they can then spread their knowledge.
It has become a consistent occurrence at many health conferences, smoking ordinance meetings and other public forums where vaping is the subject being discussed. The anti-vaping groups seemingly have nothing to lose and do anything to make sure their voices are heard.
It’s hard to believe that there is a motive larger than the critical matter of public health. That opinion is challenged when groups of researchers, such as Stanton Glantz of the University of California, San Francisco, attack the vapor industry with false facts and fearmongering. Glantz doesn’t mention that his group received a massive amount of funding from the FDA in 2018 for research regarding e-cigarettes. He is hired to be the opposition. For example, his recent tweet: “Using e-cigarettes increases exposure to toxic chemicals. For most users: They would be better off just smoking.”
His purely fictitious statement, directed at people who may not understand enough about e-cigarettes, causes vapers to question their choice. In fact, the statement should be considered criminal because it could cost human lives by sending former smokers back to combustible cigarettes. Yet, the FDA allows it to go on.
We have seen regulators act swiftly and effectively in other industries where a company or research group publicizes any unsubstantiated claims for health benefit, and this situation is no different. I would even say it’s more dangerous as they push people toward a product that is known to kill 50 percent of its users.
Sadly, the whole atmosphere surrounding nicotine has become incredibly dangerous and polarizing. You can no longer have a moderate opinion toward either side of the bench. If you support an adult’s choice to be able to use vapor products, you also support addicting children to nicotine. You cannot lobby for stricter regulations for next-generation tobacco products without advocating for the complete elimination of recreational nicotine use.
This must stop. I have reached out to many health groups as well as other organizations concerned about vapor products and youth initiation. The outreach was done with the hope of providing some understanding to what they are witnessing. With this information, we intend to make the most educated decisions on how to assist and hopefully end the reported epidemic of youth vaping.
Too many times in this process I have been greeted with bared teeth and the same common response: “We are not letting the fox into the hen house.” While I understand the cautiousness of these groups, I also believe that they are doing an entire nation of youth a disservice by not working with the people that know these products better than anyone else.
My hope is that one day soon we can all sit down and have an open and educated conversation to solve these important issues. We need to draw back the proverbial curtain with the hope of seeing what’s happening that is creating this problem of youth uptake. If we don’t, we will only continue to make drastic decisions based on what many consider to be anecdotal information.
We live in an era of mass information. It’s sad that when it comes to public health regarding nicotine, we are reliving the era of McCarthyism. In today’s world, anyone and everyone can have a public forum to advance their agenda, even if it’s evil. Do we as a nation no longer question the Stanton Glantzs of the world who spew lies while standing on a stack of taxpayer money?
It is easy to demonize “Big Tobacco” and lump everyone in the vapor industry into that box. However, the largest portion of the vapor industry is made up of businesses that have existed for fewer than 10 years. It would be irresponsible to immediately assume that all these companies operate under the same archaic agenda built by tobacco companies in the past.
The vapor industry is young and has never been given the opportunity to prove its mission to end the death caused by combustible cigarettes. Instead, the industry carries the burden of generations of misinformation and disillusion from those vehemently opposed to the tobacco industry. E-cigarettes were created as a true alternative for adult cigarette smokers, and these products continue to be the only disruptive space for those seeking safer options than combustible tobacco products.
Josh Church
Josh Church is the chief regulatory and compliance officer of Joyetech Group, the largest vapor industry manufacturer in the world.
