E-cigs vs Covid: never mind the science, let’s all just follow our instincts instead

Since the global outbreak of Covid-19, we have heard a great deal from politicians about “following the science” – a sound principle those same politicians often seem to have trouble sticking to. Even before the pandemic, of course, the word “science” was frequently invoked to justify knee-jerk or emotional responses to vaping – so how closely are the opinion-formers and policymakers following the science now?

Arguments for or against the proposition that smoking or vaping is a risk factor for Covid have abounded. Most, no doubt, have said more about the speaker’s existing attitude than any medical reality.

At the very beginning of the Covid scare, even before the term “lockdown” had entered common usage, there were reports from China that smokers were somehow at less risk from the new disease than others. It sounded counterintuitive. Smoking is well known to damage the respiratory system, so surely it would render a person more susceptible to a respiratory illness, not less? So never mind the science, let’s follow our gut reactions, our “common sense”.

 

A sorry tendency

 

Enter Raja Krishnamoorthi, Chicago businessman, graduate of both Princeton and Harvard, and Democrat member of the US House of Representatives. In his capacity as chairman of the House Subcommittee on Economic and Consumer Policy (not an obvious health role) he got very hot under the collar as early as April last year, accusing the US Food and Drug Administration (FDA) of a dereliction of duty in failing to “clear the market” of e-cigarettes for the duration of the pandemic.

Sound precautionary sense, or over-the-top, knee-jerk posturing? Either way, his position was hardly following the science. If only because the science had not yet gone there, and was in no position to offer a judgement on whether smoking, vaping or any other habit was a danger – or a protection – in the face of Covid.

And Krishnamoorthi is no lone voice, merely a prominent example of an all-too-common tendency. Speak now, find out the facts later (if at all).

The same tendency is sadly prevalent among journalists too, including those who like to present themselves as investigative, and those of a supposedly scientific bent.

This point is well made by Cameron English, in a blog post countering a recent article in the British Medical Journal which claimed, among other barely supported assertions, that “It has…been roundly disproved that smoking protects against covid-19”.

 

Ad hominem argument

 

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    Behind this lies a spat in which both sides resort to ad hominem, borderline libellous, arguments – a common tactic of those unable to support their position with hard facts – each accusing the other of being in the pocket of vested interests. English himself is writing for the American Council on Science and Health, an avowedly pro-industry organisation whose own funding, while not exactly “secret” as some have claimed, is not entirely uncontroversial either.

    While perhaps ironic, this doesn’t negate his basic point about those who see in the science just what they want or expect to see. Or his quoting of Christopher Snowdon of the UK Institute of Economic Affairs (not exactly uncontroversial either): “Far from being ‘roundly disproved,’ the evidence that smokers are at reduced risk of SARS-CoV-2 infection is much stronger today than it was when the hypothesis first emerged last March. This evidence cannot be dismissed on the basis of tenuous financial links of a handful of researchers to the tobacco and vaping industries.

    “Why do we keep seeing this strong inverse association between smoking and SARS-CoV-2 infection? Is it the nicotine? Is it the smoke? Is it something else? We do not know and we are not going to find out by burying our heads in the sand.”

    That last point, at least, seems sound enough, whoever said it, and whoever pays their bills.

     

    Some clarity at last?

     

    But that’s enough of the ad hominem stuff – let’s conclude with a piece of actual science.

    Even the title given to a paper published last week in the Journal of Primary Care & Community Health might just give some of those policymakers cause to pause for a moment: Electronic cigarette use is not associated with Covid-19 diagnosis.

    The study of nearly 70,000 smokers or vapers who sought medical care at a chain of US clinics between September 2019 and November 2020 set out from the position that “The impact of tobacco use on SARS-CoV-2 infection risk and COVID-19 severity remains unclear”.

    And its conclusion, while hedged in with entirely reasonable caveats, is: “Although e-cigarettes have the well-documented potential for harm, they do not appear to increase susceptibility to SARS-CoV-2 infection.”

    So is that the end of the argument? Probably not.

    Aidan Semmens ECigIntelligence staff

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    Aidan Semmens