Sunday, 31 October 2021

Contemptible misinformation about vaping in the Daily Mail

After the government announced the possibility of e-cigarettes being available on prescription (which has always been an option anyway), journalists went looking for anti-vaping voices to give an alternative viewpoint. As usual, the 'public health' dinosaurs Martin McKee and Simon Capewell were invited to spout their nonsense. Both feature heavily in this Sunday Times article

Capewell got an entire op-ed to himself in the Daily Mail. Almost every word of it is untrue. 

Sajid Javid's announcement that the Department of Health is paving the way for e-cigarettes to be prescribed on the NHS in England is deeply worrying.

Yes, there are still 6.1million smokers in England, and while smoking remains the leading cause of preventable death we must redouble our efforts to tackle this problem.

But as a scientist who has spent 30 years in public health research, particularly in regard to heart disease, smoking and diet, I can assure the Health Secretary that e-cigarettes are not the answer.

Worse, they will generate a raft of other health problems.

No evidence for this 'raft of other health problems' is given. He doesn't even say what he reckons they are.

When vaping first took off seven years ago, I was open to the idea that it might help reduce smoking.

They took off earlier than 2014, although that was when alleged experts like Capewell and McKee finally started paying attention to one of the biggest public health innovations of the century. Anybody who remembers their interventions at the time will find it very hard to believe that Capewell was open to any ideas other than banning them.

But with mounting evidence of the harms vaping can cause, I have become increasingly worried by the unquestioning enthusiasm on the part of some public health bodies whose first duty is to protect us.

Where is this 'mounting evidence'? Alas, he doesn't say because it doesn't exist.

Following a 2016 report by the World Health Organisation about the health risks e-cigarettes pose, countries including China and India banned or severely restricted their sale.

Two countries that happen to have state-owned tobacco monopolies. Fancy that!

England is out on a dangerous limb. Officials here have fallen for the exaggerated claims of the pro-vaping lobby, and are ignoring the health risks. The main claim, that e-cigarettes are a major aid to quitting, is wrong.

Randomised controlled trialobservational studies and ecological studies have consistently found vaping to be more effective than cold turkey, placebos and nicotine replacement therapy. A striking finding is that vaping is effective even when smokers do not intend to quit.

If that were true, why would the multi-national tobacco corporations be pushing vaping so hard? 

Because they sell e-cigarettes, obviously.

'E-cigs' are a means of attracting new cigarette smokers, as I will explain.

But he doesn't explain. Instead he says...

E-cigarettes are in fact one of the least effective quitting tools, accounting for only about 10 per cent of long-term quitters in the UK.

Most people who quit did so before e-cigarettes were on the market. It's not complicated. 

Many of those who try to quit smoking via vaping continue to use both e-cigarettes and lit cigarettes. This is a big win-win for tobacco firms. Most of the UK's 3million vapers who still smoke have no plans to quit.

There aren't three million vapers who still smoke. There are three million vapers. Two thirds of them are ex-smokers.

Next let's address the industry claim that e-cigarettes are 95 per cent less harmful than lit cigarettes, a figure based on no solid evidence whatsoever as far as I am aware. Yet this spurious figure was picked up by PHE. 

It's not an 'industry claim'. This is a scurrilous lie propagated by Capewell and McKee. The 95% figure was independently arrived at by both Public Health England and the Royal College of Physicians as the most conservative estimate of harm. It should be updated to 99.5% or whatever the science suggests is most plausible.   

More robust evidence estimates that, at best, e-cigarettes are 50 per cent less harmful. 

Complete nonsense. I've never heard this figure mentioned even by anti-vaping lunatics in the USA. As ever, no reference is provided for it. If e-cigs were 50% as harmful as smoking, they would be killing tens of thousands of people every year. In fact, they have never been credibly implicated as the cause of death of a single person in the UK, to my knowledge.

Champions of e-cigarettes say there is 'no evidence' of long-term harm. In fact, there is plenty of evidence.

They don't say that. They say that e-cigarettes are much, much safer than smoking. Cranks like Capewell respond by saying that we don't know the longterm effects, which is trivially true since they haven't been around for long enough. Now Capewell is saying that we do have evidence on the longterm effects. How? What are they?

Alas, Capewell once again fails to elaborate.

Nicotine is highly addictive while the superheating of the 100-plus flavourings used in e-cigs to disguise the taste of nicotine and produce vapour can generate harmful chemicals, many of which are found in lit-cigarette smoke.

As a user of unflavoured vape juice, I can assure you that nicotine doesn't really taste of anything. I don't know what 'superheating' is supposed to mean, but the 'chemicals' are heated at a much lower temperature than tobacco in cigarettes and - crucially - there is no combustion and therefore no smoke. There is plenty of toxicological evidence that strongly suggests that this makes the risks orders of magnitude lower than those of smoking, all of which Capewell ignores and has probably never bothered to read.

Research shows that e-cigarettes can be even more addictive than lit cigarettes which is why the use of youth-focused flavourings such as bubblegum is so appalling.

Nicotine poses a particular risk for the young because it disrupts the development of crucial brain connections.

People have been using nicotine for centuries without this brain damage being observed. It was never raised an issue with smoking among young people or older people. Insofar as nicotine 'disrupts' 'brain connections' it doesn't seem to do so in a way that causes any problems.

Personally I doubt very much that e-cig manufacturers will be submitting their products any time soon for UK medical approval. 

That is probably true. It took the whole length of an article for Capewell to say something that isn't a lie, but he got there in the end. A stopped clock and all that.

I know this is an opinion piece in a newspaper, not a journal article, but shouldn't it have been subject to some fact-checking before it was published?

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