Science and Law
10th December 2015

E-Cigarette Science: With Emerging Science Comes Junk Science

When Public Health England reviewed the evidence on the safety of e-cigarettes (e-cigs), two key conclusions were promulgated:
1) E-cigarettes were approximately 95% less harmful than tobacco/combustible cigarettes, and
2) Approximately 50% of the population does not realize that e-cigs are less harmful than smoking, a finding that has been paralleled in the U.S.

E-Cigarette Science: With Emerging Science Comes Junk Science

This post was authored by Lee Johnson, a freelance writer from the UK. Lee has been published on numerous websites, including the Ashtray Blog, and print magazines. He is currently pursuing a degree in physics. He is also part of the EcigaretteReviewed team.

When Public Health England reviewed the evidence on the safety of e-cigarettes (e-cigs), two key conclusions were promulgated:

1) E-cigarettes were approximately 95% less harmful than tobacco/combustible cigarettes, and

2) Approximately 50% of the population does not realize that e-cigs are less harmful than smoking, a finding that has been paralleled in the U.S. (see here).

While there is an expanding body of scientific evidence supporting the view that e-cigs are safer than cigarettes, the information is not making its way to the public. Why? What’s going on?

There are many potential reasons, but one is particularly important – junk science. Junk or flawed science often gets a lot of media attention and therefore becomes the basis on which people form their opinions, including opinions that vaping is dangerous and not safe. Recently, I analyzed 18 separate e-cig studies and identified many methodological and interpretation flaws in these studies.

You can read my full analysis here, but for the purposes of this post, I highlight just two key examples:

E-Cigarettes and Formaldehyde

In one of the most widely cited pieces of e-cig research, Jensen et al. evaluated the levels of a group of formaldehyde-releasing compounds in e-cig vapor.

The investigators tested the e-cig at both a low and a high voltage. At the lower voltage setting, the chemicals were not detected, but at the higher voltage setting, relatively high levels of the chemicals were found. Furthermore, the researchers used the high voltage figures to calculate the associated cancer risk for vapers as being 5 to 15 times higher than for smokers.

However, using the high-voltage setting to draw broad conclusions is not valid. Essentially, high-voltage settings would create the excessive breakdown of propylene glycol to formaldehyde and would lead to “dry puffs” – a scenario where the e-liquid vaporizes faster than it can be replenished. Dry puffs are unpleasant tasting, and e-cig users quickly detect and avoid such a scenario. By way of analogy, the highest settings on toasters will burn toast and create carcinogenic compounds, but that does not mean that eating ordinary toasted bread is dangerous to one’s health.

The fact that vapers avoid dry puffs has been confirmed in subsequent research. The later study found that vapers unanimously identify dry puffs at settings when formaldehyde levels spike. To reiterate, in reality, e-cig users are astute at detecting these settings and avoid them due to unpleasant tastes.

E-Cigarettes, Infections, and Viruses

Another study that generated much publicity involved exposing mice to e-cig vapor and infecting them with pneumonia or flu-causing organisms. According to the study, the data suggest that exposure to e-cig vapor slows a mouse’s recovery from pneumonia or flu when compared to the control (unexposed) group.

However, this study was fraught with a number of issues. For example, the researchers used such high exposure levels that many of the animals died from nicotine poisoning, and the e-cig vapor exposed group suffered from high levels of stress as well, which may have confounded the results. A more detailed debunking of this study can be found here on page 78 (a review published by Public Health England). Additionally, such animal studies are largely limited by the fact that the mouse immune function does not translate well to the human immune function (For example, see here).

Tip of the Iceberg

Similar types of methodological and interpretational issues plague many of the studies used to shed a negative light on e-cigs.

When confronted with a scientific study, it is critical to scrutinize it with a critical eye and get past sensational news reports, press releases, and even study abstracts. Limitations and other issues with scientific studies are often buried in the full text and come to light when a detailed review is conducted.

Unfortunately, the general public, e-cig manufacturers, and their attorneys often do not have the time or level of awareness to investigate the details behind every headline. Flawed conclusions are often propagated and distorted, and sadly, become the only message that is heard.

As e-cig science continues to emerge and make headlines, it is important to fully review the science to test its ability to withstand rigorous scrutiny.

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