Vaping and the several faces of ASH
Wednesday, August 15, 2018 at 13:29
Simon Clark

'Vaping is less harmful than smoking but we shouldn't assume it is safe, study warns'.

That was the headline on a report in the Huffington Post yesterday and as statements go I don't think it's particularly controversial.

After all, e-cigarettes are still in their infancy and it's far too soon to leap to any definitive conclusions. That said, based on current evidence, the risks of vaping, such as they are, do seem very small compared to smoking.

Nevertheless headlines speak a thousand words and the coverage of a 'small experimental study' published online in the journal Thorax this week hasn't done e-cigarettes any favours.

Vaping 'can damage vital immune system cells', reported the BBC.

Other headlines included 'Vaping may damage immune system and lead to lung disease, study suggests' (Telegraph), and 'Vaping can cause SERIOUS lung damage and should be treated with caution, scientists warn' (Mirror).

The study was covered in much the same way overseas. 'Vaping study shows e-cigarettes more harmful than thought' declared ABC in Australia, while the Irish Times reported, 'Vaping may not be as safe as previously thought, study finds'.

Crucially, what most if not all these reports failed to mention was the sample size. Indeed, from what I've read, only a follow-up piece in the Irish Times (Study linking e-cigarettes to lung function adds to concerns over vaping) admitted that:

With just eight human subjects, the research cannot be considered definitive. For e-cigarettes to be classified as producing the same effects as long-term smoking would require longer and bigger clinical trials.

That's right. These and many more headlines around the world were based on a study of just eight people. I'm not saying that makes the research null and void but until more studies are conducted we should probably treat it with a great deal more caution than we're being advised to treat e-cigarettes.

My colleague John Mallon has been on the radio in Ireland this morning making exactly that point. He was also invited to take part in a discussion on Cork's 96FM with two other guests but, having agreed, he was dropped without anyone telling him.

John describes the broadcast 'debate' as follows:

John Sodeau [Professor Emeritus of Chemistry at University College Cork] said smoking was like putting coal in your mouth and setting it alight, whereas vaping was like sneezing toxic droplets at other people. He spoke about third hand smoke and then compared smoking to vaping as a choice between losing an arm versus only losing a hand.

I was itching to get on and tackle him. Instead they brought on Jonathan Keane from Cork who called the whole thing scaremongering. He said he vaped because smoking left him with long term injuries. He added that everyone knew vaping was bad and nobody should try it. He then wanted to talk about tattoos. As he did so time ran out and I never got the call.

While we're on the subject of vaping it's worth noting a comment by the chairman of ASH Ireland, Dr Patrick Doorley, in the Irish edition of the Sun today. Urging smokers hoping to quit "not to use e-cigarettes", Doorley said:

“There are options that are safer and have a good long-term track record, like the drug varenicline, along with nicotine replacement therapy.”

To be fair, ASH Ireland has never hidden its lukewarm attitude to vaping. In September 2016 Doorley said:

"We acknowledge that many people are now turning to e-cigarettes to help them quit smoking. It is important that these smokers are aware that even those authorities who recommend e-cigarettes acknowledge that they may cause harm and that nicotine replacement products available in pharmacies have been shown to be effective and safe."

A few months later he went further and specifically advised that smokers wanting to quit "should not vape":

"Nicotine replacements will not give you the same hit but they can get you through cravings, especially for people who are highly addicted, for example those people who need a cigarette first thing in the morning.

"We would recommend those rather than e-cigarettes because they are proven to be effective and have proven to be safe. There is no such thing as a medicine or a pill with zero risk but they're very safe."

So, full marks for consistency.

Anyway, I was on the radio myself this morning. BBC Radio Bristol asked me to discuss a report that all NHS hospital sites in the city will be 'smoke-free' from January 1, 2019.

The policy goes further than that however because it includes a similar ban on vaping, which I also criticised.

In contrast Vicky Salt, senior policy and campaigns officer at ASH (London), welcomed the ban and said nothing at all about vaping.

To be fair her response was included only as an edited soundbite but it would be entirely consistent with ASH's general acquiescence on the subject of vaping bans.

The reality, as I've said many times, is that most advocates of e-cigarettes within the tobacco control industry are and will always be fairweather friends of vapers.

Their goal is not to accommodate vaping long-term but to use e-cigarettes as a tool to wean smokers off combustible cigarettes before tackling any use of nicotine as a recreational drug.

If others can't see this they're being wilfully blind for short-term gain.

Update: Following a gently worded email to the producer, John tells me he will now be on 96FM tomorrow. You can listen online.

Update: Listen as ASH advocates NRT but not vaping (which is banned)

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