A review by University of Mainz, led by Professor Thomas Munzel, was published last week in the European Heart Journal, with the intention of discussing the effects of cigarettes, e-cigarettes and waterpipes on the heart and lungs. Leading healthcare professors have been quick to criticise the cloudy and ‘misleading’ conclusions the review has drawn regarding e-cigarettes, with organisations such as ASH (Action on Smoking and Health) and the UKVIA (UK Vaping Industry Association) speaking out against the science behind the review.
The paper is a review of a range of pre-existing studies on the effects of e-cigarettes and tobacco on the body. The researchers looked at how the three nicotine delivery methods effected the users risk of certain illnesses and diseases such as COPD, lung cancer, stroke and even COVID-19.
It is here that the conclusions become misleading, as figures are attributed to e-cigarette use without acknowledging that the overwhelming majority of e-cigarette users were previously smokers.
Professor John Britton of University of Nottingham perfectly sums up how the findings for e-cigarettes are flawed, stating;
“This paper provides an unsystematic overview on evidence relating to the likely relative risks of nicotine use, and of questionable reliability: for example, that e-cigarette use increases the risk of chronic obstructive pulmonary disease by 194% but COPD is a disease with a lead time of decades, so to attribute a risk directly to e-cigarettes – which have been widely used for less than a decade and are almost exclusively used by former smokers – is inappropriate.”
Dr Nick Hopkinson, Reader in Respiratory Medicine at Imperial College London adds;
“Most users of e-cigarettes are doing so in order to cut down or quit smoking to reduce the risk to their health. In the UK, of the 3.6million people who vape 54% have quit smoking completely… Most of the illnesses or disease events seen in people who vape e.g myocardial infarction or COPD are likely to be due to their past smoking history, not their use of an e-cigarette.”
A history of misinformation
This is not the first time that Professor Munzel and the University of Mainz have been criticised for publishing misleading work targeting e-cigarettes, with weak science which appears to have been manipulated to support the desired conclusion. In November 2019 we wrote about a previously debunked study in which Munzel published similar research painting e-cigarettes in a negative light, without taking into account previous smoking habits. You can read about this in our post ‘E-cigarettes, smoking and the brain – the facts’.
Unsurprisingly, the paper has been picked up by various media outlets, sparking a slew of misinformed articles linking e-cigarettes to increased risk of COVID-19 and other illness. This kind of misleading information is one of the reasons so many people are misinformed about e-cigarettes, with many people still falsely believing that they are as harmful as smoking. As a number of healthcare organisations have found, this is simply untrue, and as found by PHE (Public Health England) e-cigarettes are at least 95% less harmful than smoking.
UKVIA have released a statement to help reassure those who may be concerned about the review, stating;
“The clear and decisive response of leading UK experts on this matter has been extremely encouraging. Prof John Britton (Nottingham), Prof Jamie Brown (UCL), Prof Jacob George (Dundee) and Dr Nick Hopkinson (Imperial) have all urged caution on the review’s methodologies and findings, variously describing them as ‘unsystematic’, ‘inappropriate’, ‘unclear’ and ‘misleading’.
Thanks to the scientific community and organisations like ASH and UKVIA, we can continue to debunk the junk science that targets e-cigarettes with negative press without clearly informing that other factors may have skewed the evidence, and help reassure those who are currently using an e-cigarette, or smokers who may wish to make the switch to an e-cigarette, that they are making a choice which will help improve their health in comparison to continued tobacco use.