If there’s a scientific consensus on e-cigs, it may not be quite what you think

Is there a scientific consensus on the harmfulness of e-cigarettes? If your views, like most people’s, are based largely on what you hear from mainstream media, you might well think there is.

The rash of lawsuits breaking out all over the US against Juul; the constant association of the inaccurate term “epidemic” in assocation with vaping; the frequent assertion by legislators, notably in Asian countries where smoking remains a major source of tax revenue, and by certain prominent health charities in the US, that vaping is as dangerous as smoking – all these might well lead a reasonable person to assume that statement is scientifically accepted fact. But it’s not.

As ECigIntelligence reported yesterday, the latest Cochrane review not only backs nicotine e-cigarettes as a more useful tool than others for helping smokers quit, but says nicotine-containing e-liquids “may not be associated with serious unwanted effects”.

In the words of lead researcher Jamie Hartmann-Boyce, writing for the academic news platform The Conversation: “The review found no evidence of serious harms of e-cigarettes with nicotine.”


Where does the funding come from?


It’s interesting to note that year by year, as use of e-cigarettes and the body of evidence on vaping have grown, each Cochrane review has seemed slightly more positive than the last – from a headline “cautious thumbs-up” in 2014, to “we’re still uncertain” in 2016. And it’s well worth considering exactly what Cochrane is, and where its evidence is coming from.

Based in London, it’s an independent international charity with a global network committed to gathering and summarising health research from around the world. Its reviews are therefore a synthesis of all the best research available on the topic in hand. In this case, vaping.

There is some understandable cynicism about where the money comes from to support research. Hartmann-Boyce, of the Nuffield Department of Primary Care Health Sciences at the University of Oxford, receives funding from the National Institute for Health Research, British Heart Foundation, and Cancer Research UK. Cochrane itself is funded by a long list of research institutes, health ministries and universities.

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    This latest report reviewed both the methods and results of 50 of the most scientifically rigorous studies from around the world, representing a total of more than 12,000 participants over four years. And it concluded that “No studies in any of the different comparison conditions detected serious harms considered to be related to EC [e-cigarette] use.”


    The known unknowns


    As you might expect, this conclusion comes with a health warning. While “moderately confident” of e-cigs’ effectiveness for smoking cessation, the researchers add: “effect estimates of adverse events and serious adverse events were judged to be of low or very low certainty, with the main problem being imprecision.”

    To review the review, one might say it adds up to an overall cautious support of e-cigs by the science.

    To quote Hartmann-Boyce again: “While there are still unknowns regarding possible longer-term harms of e-cigarettes, experts generally agree that e-cigarettes are considerably less harmful than smoking, even though they are not completely risk free.”

    If there is a scientific consensus, that seems to sum it up pretty well.

    Meanwhile, the number of vapers in the UK – generally considered the world’s most vape-friendly country – has reportedly fallen for the first time, apparently due in large part to people being misled about the perils of e-cigarettes. And while that might not be bad news in itself for the public health, if it means more people smoking – or fewer giving up – then it might be seen as very bad news indeed.

    Photo: PxFuel

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    Aidan Semmens