The Briefing Room
David Aaronovitch introduced experts to speak about the burning issues of the day. Linda Bauld, Professor of Health Policy at the University of Edinburgh, and Lion Shahab, Associate Professor in Health Psychology at the University College London, defended a common sense approach to vaping.
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by Dave Cross
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David Aaronovitch introduced his guests as “experts who can tell us everything about the burning issues of the day”, and the burning question of today, according to the host, was “E-cigarettes: are they dangerous?”
Aaronovitch opened the discussion by playing a recording of President Trump advocating banning flavoured eliquids. He wondered: “Why have e-cigarettes become so popular and what are the risks of using them?”
Before going to the experts, he played a recording of his trip to a vape store in London. Aaronovitch was told that the best way to begin quitting smoking was to purchase a starter kit, and the shop’s employees described to him how a vape device works. They then described what strengths they would recommend to current smokers.
Aaronovitch spoke with Hannah Kuchler, a US pharma and biotech correspondent. She gave him a skewed overview of what had happened in the USA – replaying the trope that the rash of lung diseases is linked to vaping.
This led on to a chat with Tom Novotny, Professor of Epidemiology and Biostatistics at San Diego State University. Novotny claimed that the problem in the States boils down to the fact that vaping hasn’t been tested like other smoking cessation products: “They have not gone through the regulatory approval process that gum, patches and inhalants have done in the past,” Novotny said, “that have first been used as prescription drugs then over the counter.”
Despite acknowledging the Hajek study demonstrating that vaping is virtually twice as effective as NRT products as a quit tool, Novotny added, “but that’s the only one so far,” and attempted to dismiss the findings because people also received counselling. As has been pointed out many times, this did not skew the results as all subject groups received counselling.
Then, Novotny spoke of “the increasing number” of negative studies claiming to have found negative aspects of vaping. “There’s DNA alterations caused by nicotine to changes in the cells resulting from pulmonary damage. And now what we’re seeing are reports of pulmonary injury that are now making quite a bit of news.”
“What we don’t know is what are in these things.”
Maybe it made sense to him? Probably not given his adherence to the ‘epidemic’ mantra and claims that “we have lots of evidence” to show that nicotine impacts brain development. This last point is a complete distortion of the truth.
Linda Bauld, Professor of Health Policy at the University of Edinburgh, and Lion Shahab, Associate Professor in Health Psychology at the University College London, injected some sense into the proceedings.
Linda Bauld told Aaronovitch that there were dozens of studies, completed over several years, that vaping is significantly safer than smoking. “They are a good option” for people trying to switch from smoking. She added that several trials support claims of efficacy.
She stated: “We have several good quality large trials that shows that people who are randomised to use an e-cigarette are more likely to quit smoking than people who are randomised to medicines like nicotine replacement therapy. That gives us good quality evidence.”
“They are the most popular way to quit smoking, used in over one third of quit attempts, and in population studies we see that they make a contribution to more people quitting,” Bauld added.
Lion Shahab explained that American researchers concerned about lung disease can’t be looking at the same products we have here: “There are 40 million users of e-cigarettes worldwide, in the UK there are around 3 million users, and they’ve been used for over a decade, and there has not been any kind of alert with regards to respiratory diseases.”
“This has nothing to do with the behaviour of vaping but rather the content of what is being vaped in the US. They are quite clustered…they appear to have been using products that have been adulterated and include things such as marijuana, THC and CBD – which probably use particular solvents that make them more harmful.”
“None of the products we use in the UK have been linked to any of these diseases.”
“Nicotine does not cause cancer, it is not a direct cause of heart disease, it’s the other things in tobacco that cause those conditions,” added Bauld. “I think the Americans are concerned about addiction, but they also extrapolate lots of risks that we really don’t see in the data.”
“I really think the risks have been overplayed, nicotine has been demonised because in the past it was mostly delivered through smoking.” She highlighted that although many people believe nicotine causes cancer, “that really isn’t true.”
Finally, Shahab criticised the misuse of the precautionary principle in India that removes vaping but allows cigarettes to remain on sale. Linda Bauld argued that the government should hold firm on its current stance and to continue with the current policy; “We have some of the best data in the world that shows us what’s happening. We’re going in the right direction.”
Aaronovitch concluded: “Allowing vaping to continue seems to me to be the best policy for the time being.”
Related:
- “A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy” by Hajek et al. – [link]
- “Smoke alarm: what are the risks of vaping?”, Radio 4 - [link]
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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