Today has seen a flurry of media activity following publication of research by the University of Birmingham on the effects of e-cigarette vapour on immune cells in the lung.
The BBC selected a quote early in their account – presumably from the University’s press release – explaining how “researchers "caution against the widely held opinion that e-cigarettes are safe"”. This is somewhat of a straw man argument. It is wrong to say that there is a widely held opinion that e-cigarettes are safe, in fact it is frustrating – as Cancer Research UK has noted - that such a large and increasing proportion of the public believe that e-cigarettes are as harmful, or more so, than smoking. Today’s breathless headlines can only have reinforced these misperceptions in the minds of many thousands.
Additionally, no public health organisation in the UK claims that e-cigarettes are entirely safe, just merely less harmful than combustible tobacco. It is inconceivable that the lead researcher, Professor David Thickett, is not aware of Public Health England’s assessment that e-cigarettes are at least 95% less harmful than tobacco so it puzzling where this “widely held opinion” is supposed to have come from.
Considering the widespread media attention to this study, it is important to point out its obvious limitations. Firstly, it was an in vitro study and the researchers found that e-liquid becomes more toxic to cells after being vaped than before. However, the study does not show evidence of that toxicity or any other clinical significance in living subjects.
Secondly – and allied to the first limitation – the researchers fail to come to any conclusion on quantifiable level of risk. It is OK to say that cells in a petri dish react poorly to vapour but without an assessment of how that translates to increased chance of harm in humans, it is of little worth. Even Prof Thickett is quoted in some articles agreeing that e-cigarettes are far safer than smoking, all that is of debate is by how much. It is quite possible that the resultant level of risk would be well within the margins of the 5% that PHE has identified. Rather than proving that “PHE is wrong” as Prof Thickett claimed during a radio appearance today, this research does nothing to contradict the reduced risk claims of public health organisations supportive of the harm reduction prospects of vaping. In short, it is hard to see why this is news at all.
Lastly, and probably most importantly, the researchers did not compare their findings with the effect on cells of tobacco smoke. Without this comparison and coupled with the lack of an assessment of real world risk, this study adds nothing significant to our understanding of vaping as a substitute for smoking.
In fact, there are worrying signs that the project has been approached from an ideological point of view rather than one of seeking the truth. Prof Thickett was quoted in the Telegraph commenting that “a large number of e-cigarette companies are being bought up by tobacco companies” which should be irrelevant to someone presenting research, and more in keeping with activism, which would be a conflict of interest.
The NNA would always welcome good research into the effects of vaping – many of us are, after all, vapers ourselves – but today’s lurid headlines add nothing to the debate and have more likely harmed overall public health.
Smoking is enjoyable to many and there must be a strong incentive in order that smokers switch to safer alternatives, which all agree e-cigarettes are. Today, many hundreds or even thousands of current smokers will have been given one more reason to postpone the decision to try an e-cigarette and reduce their risk, thanks to exaggerated news reports concerning a study which challenged a false premise that e-cigarettes are widely considered safe, didn’t conclude any clinical significance, failed to identify a level of real world risk, and avoided a comparison with smoking which could have put the research results into context.
In pursuing a perfect scenario, all that has happened today is that a speculative study has enabled a click-hungry media to make great strides in harming the good of tobacco harm reduction and turning many smokers away from safer products.
You can listen to our Chair, Sarah Jakes, debate with the lead author on BBC Radio Essex at 1:10:00 here.