Very critical doctors towards an alarmist study on the e-cigarette

A recent study supports that electronic cigarettes increase the risk of respiratory diseases. But the vapers studied were all... former smokers.

Is the electronic cigarette a safe alternative to tobacco?

While most international medical bodies answer affirmatively, a new study has added fuel to the fire. Published on December 16 in the American Journal of Preventive Medicine, it claims that vaping, like tobacco, increases the risk of respiratory diseases and consequently recommends not using e-cigarettes. But the study is far from flawless, which has earned it significant criticism from some doctors.

At first glance, it seems convincing. The researchers followed 32,000 adults between 2013 and 2016. They were classified into five categories: smokers, ex-smokers, vapers, ex-vapers, and finally, those who have never smoked nor vaped. Meanwhile, the study authors recorded all cases of respiratory diseases (chronic obstructive pulmonary disease, chronic bronchitis, pulmonary emphysema, asthma) that occurred during the three years of follow-up.

They then discovered that vapers had a 30% higher risk of developing a respiratory disease compared to people who have never smoked nor vaped. A misleading finding, according to Prof. Bertrand Dautzenberg, because the vast majority of these vapers are actually... former smokers! How can we know if the e-cigarette is the cause of these diseases, or if it is the years of smoking to blame? "They should have compared the rates of respiratory disease among ex-smokers who vape and ex-smokers who have never vaped," criticizes the pulmonologist, for whom vaping is a very valuable smoking cessation tool. "The worst," continues the doctor, "is that the authors probably have this data but do not disclose it."

"The rate of respiratory diseases found in this study among vapers is entirely compatible with what we observe in smokers who have never vaped," adds Prof. Dautzenberg. In other words, this study does not allow us to say that the electronic cigarette alone causes lung diseases. "All we can say is that the occurrence of respiratory symptoms is linked to smoking, that smoking and vaping at the same time does not reduce the risk, but switching from cigarettes to vaping greatly reduces this risk," the doctor continues.

This view is shared by several scientists, including Prof. John Britton, director of the Tobacco and Alcohol Studies Center at the University of Nottingham (England), who, in a right of reply published by the British newspaper The Times, explains: "These results are biased by the fact that most vapers have smoked in the past. And since smoking is a major cause of chronic lung diseases, ex-smoker vapers inevitably have an additional risk of developing these types of diseases, even long after quitting smoking."

Effects actually due to tobacco

In June 2019, the same team published a similar study, which claimed that vaping increased cardiovascular risks. "Again, the results were biased," emphasizes Prof. Dautzenberg. "It was not vaping that caused these heart attacks: it was mainly that a large number of ex-smokers who suffered heart attacks had started vaping."

For now, data on the long-term risks of electronic cigarettes are lacking. But health authorities agree that it greatly reduces the risks related to tobacco when used as a cessation aid. One study even showed that it could prevent millions of deaths. However, it can never be recommended to non-smokers.

12/20/2019, By Le Figaro, Cécile Thibert. https://www.sante.lefigaro.fr/