CHEST journal point and counterpoint – E-cigarette use for harm reduction in tobacco use disorder: Yes/No?

The September 2021 edition of CHEST, the respiratory journal, features a point/counterpoint debate on the value of e-cigarettes for tobacco […]

A debate about the merits of e-cigarettes for tobacco harm reduction

The September 2021 edition of CHEST, the respiratory journal, features a point/counterpoint debate on the value of e-cigarettes for tobacco harm reduction.  I am making the case in favour (the Point) and Dr Hasmeena Kathuria (Boston University) and Dr Frank T. Leone (University of Pennsylvania) are making the case against (the Counterpoint).  We each provide a shorter rebuttal to the arguments made by the other.  We also recorded a 30-minute podcast to air these arguments face-to-face.  Recognising the broader interest in the subject, CHEST has kindly made this content open access so far.

Whatever you think of the respective arguments, it was refreshing to find a forum willing to air them in a respectful and measured way, I am grateful to Drs Kathuria and Leone for engaging and making their case and to CHEST for providing the platform.  I wish we could have much more debate like this.

For ease of access, I have added the relevant links below.

Point – the case for vaping for tobacco harm reduction

Counterpoint – the case against vaping for tobacco harm reduction

Podcast: E-Cigarettes for Harm Reduction in Tobacco Use

Comments, disagreements, and reviews are welcome – keep it polite!

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7 thoughts on “CHEST journal point and counterpoint – E-cigarette use for harm reduction in tobacco use disorder: Yes/No?”

  1. #vapingsaveslives Well, I function and carry on having an active physical life at 68yrs., working out each morning on a
    cardio glider as a life-style option. I have
    vaped since 2010. I choose safer foods, and am not obese, though I was. I found #keto Low Carb Vapers
    and changed the way I eat. I’m stronger, and have adequate-normal lung capacity to exercise and ride a
    bicycle, something I would never have had had, had I continued the 43 years of smoking.

  2. i worry over the state of vaping and wonder how scientists can disagree so much on a subject.
    i also worry about how scientist can twist facts to meet their own agenda or rig experiments to gain the effects they desire, it makes me wonder what else in science we might have been lied to about in the past.
    i see so many blatantly false and easily provable fake claims made about vaping that it is frightening.
    seeing how respected people can make up such false garbage so easily i wonder is the world we though we knew so well built on lies and deceit.
    from proof of heart attacks & lung injury to highly to flammable e-liquid & they wont help you quit smoking, all proved wrong & millions of times in some cases.

  3. Barbara Mennitti

    Love your rebuttal: “It is important not to confuse “science” with sophistry masquerading as science.”

  4. Roberto Sussman

    Kathuria and Leone cute as evidence for pulmonary harm from vaping one of the most flawed study by Glantz and Bhatta:

    Association of e-cigarette use with respiratory disease among adults: a longitudinal analysis. Am J Prev Med. 2020; 58: 182-190

    This longitudinal study tracked COPD in vapers, smokers and never smokers for about 10 years. The smoking history of vapers was ill considered and controlled, besides the fact that COPD takes decades (not just 10 years) to develop. This study should be retracted. Other studies on pulmonary effects of vaping in humans are small sampled cross sectional studies that also fail to contol for previous smoking, compare with smokers and often fail to distinguish between accute and chronic effects. Kathuria and Leone have nothing else to show about worrying pulmonary effects, but hey will keep pounding and citing Glantz and Bhatta

  5. I smoked for 37 years, 3 pad plus 3-10 cigars. I had open heart surgery,lung surgery and smoked through both. I’dbeen diagnosed with COPD and depended on several rescue inhalers and a nebulizer still I smoked. Tried all the “recommended” products plus acupuncture counseling and meditation. None of it worked. A friend introducedme to vaping and in 3 days I accidentally quit! That was 2009. Now the science is being ignored in favor of garbage studies by lobbyists like Glantz. I’m being forced back to smoking by Governor Charlie Baker & extremists in office who politicize and lie about the science. Why? Obviously they’d rather we smoke….

    1. Anon, it’s unlikely you’ll see this as an Anon, but I hope you do. You note that “garbage studies by lobbyists like Glantz” and by “Baker & extremists in office who politicize and lie about the science. Why?

      The Answer to that becomes fairly obvious, and shows itself to be a variety of answers, if you take a couple of minutes to read this very brief summary of my article in Signs Of The Times titled, “Types of Antismokers” at

      The basic analysis was done 20 years ago, but has not really changed much when you look at how the Antivapers fall so readily into categories like The Moralists and The Greedy etc. If I was writing the same analysis today, I *might* include one more category although it doesn’t fit quite as neatly on its own as the others do: namely, “It **LOOKS** like smoking!”

      If Big Pharma had come out a dozen years ago with a thing that looked like a fist-sized metal box that you could inhale nicotine mist through and then produce no visible emission, and if that remained the ONLY “vaping type” action on the market, I believe you would see a see a strong reduction in resistance to it… even if the other categories might still be opposed.

  6. Thanks to CHEST for providing a platform for this discussion and thanks to Dr. Leone and Dr. Kathuria for attending.

    So far, so good. The arguments of the two doctors, however… Incredible, that Glantz and Bhatta are still being quoted. Studies by Dr. Polosa, Dr. Farsalinos and others are ignored and studies that even a layperson can point out the flaws are used again and again against vaping.

    My COPD went into regression after I switched to vaping. My once much too high blood pressure is back to normal and I’m fitter now at 60 than I was 20 years ago.

    The only negative thing I can say about vaping is that since I switched I’m living in constant fear of being forced back to smoking again.

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