An e-cigarette is a battery operated device that may or may not look like a traditional cigarette. Instead of igniting the tobacco-filled tube of a cigarette, users inhale a heated, flavored nicotine liquid vapor which is produced by means of a rechargeable battery inside the device. The inhaled vapor provides a hit of nicotine and the exhaled vapor looks like smoke, but does not contain the thousands of chemicals found in traditional tobacco cigarettes or the awful smell. E-cigarettes came onto the U.S. market in 2007, and while it’s already a booming business raking in billions of dollars, not much is still known about the long-term health affects of using these devices. Now a UK study has proclaimed that e-cigarettes are less harmful than tobacco and has given them a high seal of approval. Considering e-cigarettes have been on the market less than 10 years which is not enough time to conduct long term health studies, it seems premature to provide such an approval.
The UK report was produced for Public Health England and was based on findings from other studies. The results seem to be making headlines worldwide and some of their statements are interesting, to say the least. One such statement under the Executive summary states “whilst there is some experimentation among never smokers, regular use among never smokers is rare.” Perhaps this “rare use” may be true in the UK as they report around 2% of youth is using electronic cigarettes at least monthly. However, the U.S. findings on youth and e-cigarettes (EC) appear much different.
According to the U.S. Centers for Disease Control Morbidity and Mortality Weekly Report, “current e-cigarette use among middle and high school students tripled from 2013 to 2014” and “current e-cigarette use has surpassed current use of every other tobacco product overall, including conventional cigarettes.” Here in Florida, current cigarette use among high school students is at an all time low at 7.5%, but current e-cigarette use is averaged at 10.8% overall, but higher for males and whites when the results are broken down. So much for this rare use.
Another statement under Key messages says, “there is no evidence that EC are undermining the long-term decline in cigarette smoking among adults and youth, and may in fact be contributing to it.” According to the MMWR link above, when you take into account e-cigarette and hookah use, “the increases in use of those offset declines in use of more traditional products such as cigarettes and cigars. There was no decline in overall tobacco use between 2011 and 2014.”
While the electronic cigarette industry may be celebrating this latest study, the information within sounds reminiscent of how the cigarette industry paid “experts” to downplay the dangers of cigarette smoking. The study continually promotes EC as a cessation aid and urges public health officials to relax restrictions, and even license the devices as a medicinally licensed product through their health system. They even suggest that the “use of the gateway terminology be abandoned until it is clear how the theory can be tested in this field.” As you read through the study either the information doesn’t make sense at all, or claims made seemed too good to be true.
As new information comes out today regarding the conflict of interest of some of the authors, the celebrations may be over. “Three of the 11 authors of that study disclosed their role advising the e-cigarette industry in the original text of their paper.” An Italian author has links to an e-cigarette distributor and pharmaceutical companies, and a U.S. author has links to “several manufacturers of smoking cessation products…” A Swedish scientist “admitted to being a ‘consultant for most companies with an interest in tobacco dependence products.'”
Those who issued the report are standing by its claims, citing an “expect review” had already endorsed the findings, although the “authors themselves accept (the work) is methodologically weak.” A statement at the beginning of the paper says “Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities… through world-class science, knowledge and intelligence…” They may have let the public down on this one. One statement in the report that can be agreed upon is found in the Key messages: “Continued vigilance and research in this area are needed.”