This week a lot of people will be once again unnecessarily alarmed by the sensationalist nature of national news headlines about the safety of vaping. Before jumping to the same conclusions, we think it wise to look objectively at the detail of the reported study.

While the media have drawn some “click bait” headlines from this, careful reading of the study itself tells a completely different story.

Limitations of the study

Let’s look at three of the most important limitations of this study.

 – The study was in vitro, which means on individual cells under a microscope, not in a living person.

– The study used cells from just eight volunteers, a tiny study group.

– It made no comparison to the effect of cigarette smoke in the same conditions. 

Nature of the study

How about the nature of the study itself?  Without going into too much detail, cells were taken from 8 volunteers and then ‘exposed’ to an aerosol containing vapourised e-liquid. After exposing the cells for 24 hours, there was evidence of ‘cell toxicity’ which had an impact on alveolar macrophages (white blood “dust cells”) which meant that they couldn’t function properly. The study concludes e-cigarette users may suffer from impaired bacterial clearance of lung tissue, potentially leading to irritation or infection, but acknowledges further research is required.

The study itself uses a lot of presumption and inference, “it could, this might”, and it also has a lot of further limitations, including the following quoted directly below:

“…we have used an in vitro study on primary AMs with exposure levels which may not be physiological”

“…it is difficult to determine an optimal dose of nicotine exposure”

“It is not possible to determine a standard nicotine dose for smoking experiments as each individual will titrate their nicotine intake to match their requirement.”

“AM exposure in vivo will also vary according to techniques used by users to modify their nicotine intake, such as depth and frequency of intake as well as breath-holding/expiration”

“…our model represents an acute exposure, rather than a chronic exposure system which is better suited to in vivo animal experiments.”

What does all that mean?

It means that this is preliminary research, and any speculation on e-cigarettes causing lung damage is a matter of conjecture. There is potentially no way to accurately ‘dose’ cells in the way people vape in the real world, and this is always the problem with this type of study. Vapers lungs are not full of vapour 24 hours a day, and interestingly several direct studies of human participants “in vivo” have already been carried out.

An observational study was published last year by Professor Riccardo Polosa in which the health impact of e-cigarettes was measured on a group of never before e-cigarette users. No significant changes could be detected in the lung function at the end of the 3.5 year period compared with the initial lung function of the participants. This finding is far more significant than a 24 hour cell line study in a petri dish.

Reading down a long way from the frightening headlines, the BBC journalist actually says there is overwhelming evidence that vaping is far safer than smoking – a view held by the vast majority of government and non-government health organisations working in this area.

Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies:

“The harsh truth is that smoking kills, and smokers who switch completely to electronic cigarettes are likely substantially to reduce the likelihood of premature death and disability,”

Seeing more studies of vaping is great, we welcome research. But we need a balanced debate on the relative risk of e-cigarettes in comparison to combustible cigarettes, and once again, since bad news attracts more clicks and sells more papers, a very unhealthy bias has appeared in every major news item we have read.  It is simply not reflective of the findings of the report. The consequence of such negative headlines must surely be that fewer smokers will make the life changing decision to switch to vaping.

We can only hope is that it doesn’t reverse the decisions of people who may have made the switch from cigarettes to vaping – and if anyone does ask you, the news articles quite simply got it wrong in this case.

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