I wrote to an academic at Manchester Metropolitan University, Dr Maxime Boidin, about generating irresponsible publicity based on false interpretations of unpublished data. The letter is reproduced below.
Dr Maxime Boidin
Senior Lecturer
Cardiac Rehabilitation
CC: Michael Thompson, Head of Governance
26 February 2025 (updated)
Dear Dr Boidin,
Re: Irresponsible publicity related to an unpublished vaping study
I write to request that you stop the irresponsible promotion of your incomplete vaping study and follow a credible scientific process for releasing its findings. The study has received considerable publicity. For example, the following:
- Vaping horror as first ever study reveals deadly side effects – heart disease, organ failure, dementia (Mirror, 23 Feb)
- Vaping horror as first ever study reveals deadly side effects (Manchester Evening News, 23 Feb)
- Vaping ‘more dangerous than smoking’, bombshell first-of-its-kind study reveals – it raises risk of THREE deadly diseases (Mail, 24 Feb)
I am a long-standing public health advocate and analyst, and have been engaged in the tobacco science and policy field since 1997. I was previously the Director of Action on Smoking and Health (UK) and a senior civil servant. Now I run my own consultancy. I am disturbed by what you are doing with this study.
Here are some things for you to consider:
- You have not published the study, and from the reporting, it seems you have not even completed it. There is no published paper, pre-print, protocol, trial registration, or even conference abstract. There is no information on the participants, how they were selected and their smoking history. Nor have you disclosed competing interests or funding information. Yet, you are making alarming statements to the media about the findings of a study no one else has seen. It is unethical and unacceptable to conduct science in this way.
- You are making statements to the media that are claiming an equivalence in risk between smoking and vaping or even suggesting that vaping may be worse. “What we have found is the dangers for someone who keeps vaping are no different from smokers.” There is no basis for you to make this claim and a large body of evidence that shows that this claim is false. Extraordinary claims demand extraordinary evidence, but you have not provided any evidence, let alone enough evidence, to support this claim.
- From the newspaper descriptions of your methods, one can speculate that you have been measuring the acute cardiovascular effects of nicotine use and nicotine withdrawal. Nicotine is a well-known stimulant with a well-known effect of arterial stiffening. You have drawn conclusions from measurements in fairly unusual experimental conditions (acute nicotine withdrawal and temporary fasting). This effect is common to many forms of stimulation, and it is not directly linked to long-term cardiovascular outcomes. This same story (the “discovery” of acute arterial stiffening in e-cigarette users) has been written before (e.g E-cigarettes are as bad for you as SMOKING, a new study has claimed (in The Mirror). You can read my review of such a study and the related media coverage here: When you thought public health could go no lower – it just did (2016). I do not know precisely what you have done, but that’s the point: you are evading scrutiny.
- Sadly, you are not the first to find this, and you are not the first to hype the findings into generalised statements about the relative health risks of smoking and vaping. However, such potent claims cannot be made on the basis of acute responses to nicotine use. They demand consideration of long-term cardiovascular risks based on meaningful biomarkers, but your study cannot do this. It would also require estimates of cancer and respiratory disease risks, but your study does not attempt to address either. You have no basis for making claims about conditions like dementia or organ failure from measurements of Flow Mediated Dilation (FMD). I assume you have seen this recent paper:
Storck, M., Kröger, K., & Rammos, C. (2025). Caffeine and nicotine acutely inhibits flow-mediated vasodilation, but not both are necessarily harmful in the long term. VASA. Zeitschrift Fur Gefasskrankheiten. https://doi.org/10.1024/0301-1526/a001167
“acute FMD effects cannot always be equated with long-term damaging effects” - A further criticism has been made by the American expert, Professor Michael Siegel of Tufts University, Researchers of Severely Flawed Study Conclude that Vaping is Just as Harmful as Smoking and Causes Heart Disease and Dementia (25 Feb). Siegel highlights the problem of the residual effects of years of smoking exposure in current vapers. “Thus, this study did not show that vaping is no better than smoking. Instead, what it showed was that the respiratory function and exercise capacity of ex-smokers takes a while to return to normal.” He concludes: “If this study is eventually published — and no reputable journal would do so — it will be too late to reverse these headlines.”
- You might object to the points raised above, and they are based on indirect understanding of your work through accounts in tabloid newspapers. That is why there is a process for scientific publishing and post-publication scrutiny: authors can address criticisms or accept the limitations of their work, and make appropriately qualified comments about their findings. Journals can decide whether the work merits publication and assess the significance or otherwise of the findings.
- Your specialism is in sports science, a respectable discipline. However, you have little experience in the smoking and vaping field. You have not explained why meticulous, credible assessments that find that vaping poses only a small fraction of the risks of smoking are somehow mistaken. These include assessments by the government’s Office of Health Improvement and Disparities (Nicotine Vaping in England, 2022) and the Royal College of Physicians (E-cigarettes and harm reduction: an evidence review, 2024), all involving surveys of the published literature, including the acute effects of nicotine.
- It is, of course, possible for plucky outsiders to overturn a scientific consensus among complacent practising scientists in the relevant field. And we should celebrate such iconoclasts when they triumph. However, to claim the mantle of Galileo, you must first publish the science and subject your analysis to scrutiny, not just make wild claims in newspapers. To make heroic projections of vaping mortality risks relative to smoking, you should assess the full spectrum of harms caused by smoking and not just use a small sample of vapers and a few measurements, which are, at best, poor markers for longer-term cardiovascular outcomes only.
- Many scientists and academics are facing pressures to secure funding and demonstrate impact, but few would resort to this. I see from your Twitter/X feed that you are proud of The Mirror coverage. You should not be. While it may help with fundraising and offer personal and institutional prestige, it is profoundly irresponsible for scientists to communicate in this way. If people are led to believe that there is no difference in risks between smoking and vaping, they will be less likely to switch from high-risk to low-risk nicotine use, more likely to relapse, and less likely to divert from smoking initiation. While you may feel some satisfaction from the publicity for your unpublished, unscrutinised work, you may be carelessly leading people towards disease and death. Six million adults still smoke in the UK, what do you think the effect of your highly publicised claims will be on them?
- It is tempting to blame the media, and we should. But it is no secret that the media has increasingly debased itself in its lust for clicks and engagement and that scientists can easily manipulate credulous journalists with alarming clickbait. High-quality, sceptical scientific journalism is becoming increasingly rare. That should not be a signal for opportunists to jump at the opportunity but for scientists to raise their own standards of communication and integrity.
I would like to end more positively, but I cannot. What you have done here ranks with the worst kind of misinformation of the tobacco industry of the 1970s and will likely have the same effect – more smoking, disease, and death. I do not expect you or the university will do anything to address this lamentable situation. However, I am copying this letter to Michael Thompson, Head of Governance and the Secretariat Team, in the hope it will cause some reflection on the governance of reckless publicity-seeking by its staff.
Yours sincerely
Clive Bates
Counterfactual Consulting
London
E: [email protected]
Disclosure: I have no competing interests or funding from vape or tobacco companies.
Well said Clive, I read the newspaper article and found myself in a state of disbelief at the lack of actual facts or evidence in the article. We know nicotine like caffeine are stimulants and have a transient effect on blood vessels and the heart due to brief constrictions of arteries, the important word is transient, because the effect quickly passes.
Thank you for publishing this justifieable challenge to the actions of Dr Boidin and to his unpublished “evidence”
To Clive Bates,
I can see your point to some degree about irresponsible publicity as a general issue. However using and supporting the use of e—cigarettes to illustrate your point is at best naive and at worst harmful because you do not seem to show any understanding of the significant research background to this study and also emerging evidence from other research groups that all suggest different but equally significant harm to human health. Whilst I support your mission to reduce cigarette use but this does not mean that e-cigarettes come without significant harm. On the contrary, The background to the research is already compelling. Your suggestions of waiting to see the long term effects from use over years is frankly unethical when there is evidence of short terms harms. E-cigarette manufacturers absolutely should not get to have years to embed e-cigarette use and damage health, create even bigger public health issues that would be even harder to change from social and medical (much like cigarettes and tobacco)!!
This is especially relevant due to the woeful lack of regulation of devices, variation of strengths and quantities of nicotine doses in different devices. In addition to this, the risks that are well documented related to spontaneous combustion, fire and environmental impact (from disposable, single use devices) should not be overlooked.
Whilst you choose to criticise this one study and you rwally not aware of the other studies being conducted and published?
In particular, a new systematic review says,
“ For pregnant women and adolescents, e-cigarette use poses particular concerns due to nicotine’s developmental effects.120,121 Adolescent e-cigarette use may increase the risk of cigarette smoking during pregnancy.122 Public health policies must balance the potential benefits for adult smokers with the need to protect vulnerable populations”
Whilst this research team do agree with you in part saying,
“ Researchers caution against conceptualizing e-cigarettes as equivalent to traditional cigarettes”
This absolutely should not overshadow the bigger picture, advice in the medium term that:
“Special focus should be given to pregnant women, emphasizing the risks of e-cigarette use during pregnancy and its potential long-term effects on fetal development.”
And concludes that:
“ This review provides robust evidence of the harmful effects of e-cigarette exposure on human barrier systems. Through mechanisms such as oxidative stress and inflammation, e-cigarettes compromise the integrity of pulmonary, vascular, and neural barriers, leading to long-term health risks. These findings underscore the urgent need for public health policies to regulate e-cigarette use, particularly among adolescents, pregnant women, and other vulnerable populations. Further research is needed to fully understand the chronic effects of e-cigarette exposure and to develop safer alternatives.”
The full article can be found at:
https://www.sciencedirect.com/science/article/pii/S1931524425000118