You may have seen news headlines surfacing over the past few days relating to vaping and respiratory illness. These headlines are based on yet another poor-quality study which lacks scientific credibility and has been used to further boost anti-vaping propaganda through the mainstream media.
The ‘study’ comes from the USA, a country which has a substantial tobacco lobbying history and a well established reputation for the publication of poor-quality research with hidden agendas. It was published in the American Journal of Preventive Medicine and one of the lead authors is particularly noteworthy… Professor Stanton Glantz.
Glantz has a notorious history of shamelessly lambasting the vaping industry in the USA. Presenting poor-quality, agenda driven anti-vaping research seems to be his forte and his latest work undoubtedly follows this trend.
Poor-quality research by Glantz
In his latest bid to undermine the vaping industry and the concept of harm reduction, Glantz has published a study which claims an association between vaping and respiratory disease. The study’s conclusion states “Use of e-cigarettes is an independent risk factor for respiratory disease in addition to combustible tobacco smoking. Dual use, the most common use pattern, is riskier than using either product alone.”
The study was based upon statistical analysis of a Population Assessment of Tobacco Health (PATH) survey conducted between 2013 and 2016. The survey asked participants to self-report if they had been diagnosed with a lung or respiratory disease. Statistical analysis of the collected data led the researchers to the conclusion that dual users were more likely to be diagnosed with a lung disease than those who continued to smoke exclusively.
Fundamentally flawed “research”
This conclusion cannot be supported due to one glaring omission from the researchers’ statistical analysis. The lack of control for history in combustible tobacco is imperative. Whilst they claim they have controlled for combustible tobacco smoking, they actually have not, as their approach lacks the detail of lifetime duration and intensity of smoking required. .
Glantz’s ‘control’ for combustible tobacco smoking was simply to ask participants if they were: current smokers (smoked every day or some days regardless if they had had smoked 100 cigarettes in their lifetime); former smokers (do not smoke now but have ever smoker, even one or two puffs); or never smokers (not even 1 or 2 puffs).
This control method is far too simplistic to be considered a robust statistical control for combustible tobacco smoking. The reason why is because it doesn’t take into consideration smoking history. Within this current smoker group, some respondents may be 60-a-day smokers, others may just have four or five cigarettes a week.
An overwhelming amount of evidence shows that those heavy smokers are of more likely to develop respiratory disease and this can take decades of heavy smoking to manifest and develop; much longer than three years. The vast majority of vapers are previous smokers whom have an increased risk of developing respiratory disease due to their previous smoking history and this has not been adequately accounted for by the statistical methods employed by Glantz.
In short, there is an established correlation between smoking and respiratory disease such as COPD, chronic bronchitis and emphysema. However, there is no evidence of correlation between vaping and respiratory disease, and this study certainly doesn’t show that there is. In fact, to the contrary, it is believed that switching completely to e-cigarettes has a positive effect on the symptoms of patients suffering from COPD and other smoking-related respiratory diseases.
Study authors acknowledge switching to e-cigarettes may help reduce respiratory disease
The study even admits that switching exclusively to e-cigarettes helps reduce the risk of COPD, but brushes it aside within the conclusions, and tries to counteract it with specious conclusions. It states “Although switching from combustible tobacco, including cigarettes, to e-cigarettes theoretically could reduce the risk of developing respiratory disease, current evidence indicates a high prevalence of dual use, which is associated with increased risk beyond combustible tobacco use. In addition, for most smokers, using an e-cigarette is associated with lower odds of successfully quitting smoking.”
Using an e-cigarette is not associated with lower odds of successfully quitting smoking in the UK. In fact, a Randomised Control Trial (RCT) study earlier this year provided compelling evidence that e-cigarettes are considerably more effective than traditional NRTs.
Despite this great success over the past 5 years, this type of story does have a detrimental effect on public health as smoking is the leading cause of preventable death in the UK. There is still a lot of work to do in helping more UK smokers ditch the cigarettes. We hope both smokers and vapers can cut through the fake news and know where to find the facts.
Highly respected public health bodies such as Public Health England, Cancer Research UK and Action on Smoking and Health are the places to find reliable research and advice. Unfortunately, in the modern age, the top lines of newspapers are certainly not, particularly when it comes to vaping.