Vaping is still at least 95% lower risk than smoking – debunking a feeble and empty critique

An empty and feeble critique misses its target and adds nothing

This paper turned up in my weekly search of PubMed.

Invalidity of an Oft-Cited Estimate of the Relative Harms of Electronic Cigarettes.
Eissenberg T, Bhatnagar A, Chapman S, Jordt SE, Shihadeh A, Soule EK.
Am J Public Health. 2020 Feb;110(2):161-162. doi: 10.2105/AJPH.2019.305424.

The commentary claims to show the “invalidity” of the statements made by Public Health England (PHE) and the Royal College of Physicians (RCP) regarding the relative risk of vaping and smoking – in short that vaping is likely to be at least 95% lower risk than smoking.  As this is an important harm-reduction risk communication, it is worth asking: how valid is this critique?

I thought this might be a better critique than it actually is. But somewhat to my surprise, it is very poor indeed.

Short version

At best, the authors try to show the absolute risk of vaping is not zero and that some harm is plausible. In doing so, they are refuting a claim that neither PHE or RCP make and challenging an argument not used by anyone sensible in tobacco harm reduction. However, not a single word of their paper addresses the supposed foundation of their critique – that PHE/RCP are wrong and the risks of vaping are likely to exceed five per cent of those of smoking. As well as a number of baseless assertions that are not even relevant to the “at least 95 per cent lower” relative risk claim (gateway effects, smoking cessation efficacy and second-hand aerosol exposure), there is just nothing in the paper about the relative magnitude of smoking and vaping risks. No analysis, no data, no evidence – nothing that discusses relative risk and why PHE/RCP are supposedly wrong. Niente. Nada. Rien. Nichts. Nothing.

New (20 Jan 2020). See concise comment on PubPeer here: A critique that does not even address its target

Anyway, despite being an empty and feeble piece of work, it does provide an opportunity to discuss some of the issues raised, so I will proceed with a critique.

Longer version

The authors’ supposed refutation of PHE/RCP rests on six propositions.  You can read the article here and I will respond to the authors’ main points in the order they make them. Continue reading “Vaping is still at least 95% lower risk than smoking – debunking a feeble and empty critique”

A critical review of an Australian anti-vaping polemic

John Maynard Keynes: “when the facts change, I change my mind. What do you do sir?”

Normally, I just ignore anything written by Professor Emeritus Simon Chapman, a retired academic and noisy tobacco control activist from Australia. It’s usually just too error-laden and irritating to bother with and, on the ‘bullshit asymmetry principle‘, one could spend a whole life correcting his endless misunderstandings and mistakes. But because the Australian parliament is considering these issues, I have made an exception for his latest piece of irresponsible anti-vaping propaganda.

This was published in the Sydney Morning Herald: Keep TGA control of e-cigarettes or risk repeating the smoking health disaster 20 June, 2017. I hope the SMH will give some space to a credible Australian to provide its readers with a more realistic perspective.  In the meantime, here is a critique of the article, with extracts of the original in quotation blocks and a commentary below each block.  Continue reading “A critical review of an Australian anti-vaping polemic”

Do not read this or discuss it and in no circumstances should you comment

Australian Council on Smoking & Health Parody of the 1953 meeting between Big Tobacco and PR company Hill & Knowlton
Warning: misleading people about the benefits of e-cigarettes is logically and morally equivalent to misleading people about the harms of smoking

A new discussion paper on e-cigarettes has come out in Australia. “Options to minimise the risks associated with the marketing and use of electronic nicotine delivery systems [ENDS] in Australia” by Professor Chapman and some of his following at the University of Sydney. [PDF – 8.5Mb or via Scribd as embedded below or linked here]. Continue reading “Do not read this or discuss it and in no circumstances should you comment”

Anti-vaping zealots write flat-earth letter to The Times

MckeeTimesA remarkably self-regarding letter is published in The Times (London) today.  The writers are reacting with hostility to the outstanding Royal College of Physicians report, Nicotine without smoke: tobacco harm reduction, and the very positive editorial in The Times (Vaping Vindicated) that followed its launch.

In my view, their letter is truly dreadful, but it is also very revealing. In this post, I take a look at the arguments they make.

Update 2 May: my reply published in The Times.

Continue reading “Anti-vaping zealots write flat-earth letter to The Times”

Response to Professor Chapman’s blog about my views on e-cigarettes

Blog header
Personalised attack

Professor Simon Chapman of the University of Sydney has used his BMJ blog platform to mount a quite personalised attack on my views on e-cigarettes drawing bizarre conclusions from imagined inconsistencies in statements I made about completely different things separated by 15 years and a lot of change. I’ve submitted a comment to the BMJ, but for all I know it will be held in moderation for days while the blog is circulating freely. So here is a copy of my attempt at a dignified response.  Continue reading “Response to Professor Chapman’s blog about my views on e-cigarettes”

The Worst Letter of 2014 – a review

Click to view letter on The Lancet web site
Winner! The Worst Letter of 2014

The 13 December letter by Professors Glantz, McKee, Chapman and Daube published in The Lancet wins my prestigious Worst Letter of 2014 award. There now follows a detailed review…

Continue reading “The Worst Letter of 2014 – a review”

Turning the tables on public health – let’s talk about the risks *they* create

I’m here to tell you what to do, not to take responsibility for it

I’ve had enough of the one-sided conversation about the risks associated with e-cigarettes… poisons, gateways, renormalisation, fires, explosions, MRSA, pneumonia, dual use, undermining tobacco control, nitrosamines, anti-freeze, particulates, heavy metals, dead dog, dead cat…. blah blah blah.

ENOUGH! The public health establishment is conspicuously failing to recognise the risks associated with its preferred policy responses to e-cigarettes: with not having e-cigarettes, with banning snus, with prohibiting vaping in public places, with confusing people about risks, with controlling everything.  They carry on as if these risks are zero or somehow not their responsibility – but they are all plausible and all end in more smoking and more cigarette sales. We need to press them much more assertively on the risks they create and the harms their ideas may do:

  • “do you accept these risks are plausible and can you see how and why they might arise?”
  • “what evidence do you have regarding these risks?”
  • “what make you so confident your policy ideas will not cause more harm than good?”
  • “at what level of risk would you stop advocating these policies, or at least call for more evidence?”

For almost every policy idea there is for regulating harm reduction, there is a realistic risk that it will make things worse for health. And for almost every theoretical risks from vaping, there is a more plausible theoretical benefit. Let’s consider the following:
Continue reading “Turning the tables on public health – let’s talk about the risks *they* create”

Where is the humility? Where is the empathy?

DRChristian
He gets it, why can’t the public health establishment?

With the approach of 2014 and New Year resolutions under negotiation, my thoughts and good wishes turn to all those smokers out there who would like to stop smoking – as in stop inhaling burning particles of organic matter and hot toxic gases deep into the lungs. I hope they give vaping a try.  An e-cig is working well for my brother and I’m really glad about that – he’s smoked for about 30 years and has never intended to stop, but this has all but ended his smoking over the last nine months. Not good enough for MHRA, Brussels, WHO and CR-UK of course, but he’s pleased, and so am I.  It reminds me that there are great stories about e-cigs, about personal triumphs, lives transformed and people getting back in control.  I love these stories.

But there is a striking contrast between the often moving, thrilling and visceral human stories told by vapers and the attitude and language of the bossy bureaucrats and fake experts in public health who claim to know better. I ask where is the humility?  Where is the empathy? Some examples from them, and then we can contrast these with the words of vapers: Continue reading “Where is the humility? Where is the empathy?”