95% Safer Figure Still Holds
Simon Chapman has contributed to a paper attempting to refute the 95% safer figure – but ends up producing an “empty and feeble piece of work”
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by Dave Cross
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Chapman joined Thomas Eissenberg, Aruni Bhatnagar, Sven-Eric Jordt, Alan Shihadeh and Eric Soule in their concerted effort to nullify the claim that vaping is at least 95% safer than smoking (1).
Eissenberg works as a consultant in anti-vaping lawsuits from time to time and Jordt continues to receive funding from the pharmaceutical industry. Chapman’s credibility is pretty much shot following a statement he recently gave where he acknowledged that vaping is safer than smoking and the Australian approach he supports will drive a number of vapers back to smoking.
The 95% safer figure has been supported by Public Health England (PHE), the Royal College of Physicians (RCP), and a number of other UK public health bodies. They attempt to nullify it by referencing a collection of (mainly American) studies (2) detailing evidence of nonsense including “ultrafine particles” and “acute lipoid pneumonia”.
Renown harm reduction expert Clive Bates commented: “I thought this might be a better critique than it actually is. But somewhat to my surprise, it is very poor indeed.”
He added that their paper was, “a feeble and empty critique”.
Bates wrote on his Counterfactual blog (3): “At best, the authors try to show the absolute risk of vaping is not zero and that some harm is plausible. In doing so, they are refuting a claim that neither PHE or RCP make and challenging an argument not used by anyone sensible in tobacco harm reduction. However, not a single word of their paper addresses the supposed foundation of their critique – that PHE/RCP are wrong and the risks of vaping are likely to exceed five per cent of those of smoking. As well as a number of baseless assertions that are not even relevant to the “at least 95 per cent lower” relative risk claim (gateway effects, smoking cessation efficacy and second-hand aerosol exposure), there is just nothing in the paper about the relative magnitude of smoking and vaping risks. No analysis, no data, no evidence – nothing that discusses relative risk and why PHE/RCP are supposedly wrong. Niente. Nada. Rien. Nichts. Nothing.”
Dissecting their six points, Bates goes on to say:
- They make a serious error to say the 95% figure comes from a 2013 paper. “PHE and RCP assessments were made by their own independent expert scientists in the course of formulating their extensive evidence reviews in 2015 and 2016 respectively (PHE 2015, RCP 2016).”
- “The authors claim that advances in e-cigarettes – notably the rise of nicotine salts – make them more dangerous. Yes, they are different: today’s electronic cigarettes are better than in 2013. This is known as ‘progress’ and this also includes progress on safety and risk reduction.”
- On toxicity: “Yes, in vitro studies – cells outside the body exposed to vapour aerosol – do show some effects on cells. This is unsurprising. However, many of these studies use excessive (or opaque) exposures that are poor analogues for human exposure, and often without credible cigarette smoke comparators.”
- On harm: “The authors cite a study where the observed effects are obviously confounded by cigarette smoking and then point to relatively trivial (and often transitory) symptoms associated with e-cigarette use (‘wheezing’). They misrepresent the acute cardiovascular risk data, misrepresent the evidence on carbonyls. Once again, they fail to show that any harms they do identify come anywhere close to five per cent of the massive toll of harm done by smoking.”
- “The authors claim that vaping causes more smoking through gateway effects and reduced smoking cessation – an endlessly refuted claim. It isn’t even relevant to the relative risk of vaping and smoking and the 95 per cent claim that is the subject of this paper”.
- Finally, on being harmless: “It is not enough to assert that there is a non-zero absolute risk to challenge a claim about relative risk, in this case on second-hand exposures. Once again, this section is not really relevant to the PHE/RCP relative risk claim, which is directed at active users. Even if indoor vaping is regarded as a nuisance and matter of poor etiquette by some, it is unlikely to present remotely the kind of risks caused by second-hand smoke.”
References:
- Invalidity of an Oft-Cited Estimate of the Relative Harms of Electronic Cigarettes - https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2019.305424
- Supplementary evidence for the paper - https://ajph.aphapublications.org/doi/suppl/10.2105/AJPH.2019.305424/suppl_file/eissenberg_201927008_supplemental_appendix_a.docx
- Vaping is still at least 95% lower risk than smoking - debunking a feeble and empty critique - https://www.clivebates.com/vaping-is-sill-at-least-95-lower-risk-than-smoking-debunking-a-feeble-and-empty-critique/
Dave Cross
Journalist at POTVDave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.
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