Study Concludes that Higher Intensity Puffing Required for E-Cigarettes May Have Adverse Effects on Health, But Doesn't Consider Toxicity of the Vapor

A new study published online ahead of print in the journal Nicotine and Tobacco Research finds that electronic cigarettes require higher intensity puffing than conventional cigarettes and concludes that this may result in adverse health effects.

According to the study: "Except for one brand, higher vacuums were required to smoke e-cigarettes than conventional brands. Smoke/aerosol density was stable for conventional brands and for e-cigarettes over the first 10 puffs; however, aerosol density of e-cigarettes dropped during subsequent smoking, and higher vacuums were required to produce aerosol as the puff number increased."

The study concludes: "Generally, e-cigarettes required stronger vacuums (suction) to smoke than conventional brands, and the effects of this on human health could be adverse. The amount of aerosol produced by e-cigarettes decreased during smoking, which necessitated increasing puff strength to produce aerosol. The decreased efficiency of aerosol production during e-cigarette smoking makes dosing nonuniform over time and calls into question their usefulness as nicotine delivery devices."

The Rest of the Story

This paper seems to be missing one major point: it is the toxicity of what you are smoking or vaping that makes it harmful, not simply how hard you are puffing.

Increased intensity of puffing on electronic cigarettes compared to conventional cigarettes would only make vaping more harmful if the constituents of electronic cigarette vapor were harmful to begin with. The abstract omits any mention of the fact that conventional cigarettes contain perhaps tens of thousands of chemicals and more than 40 carcinogens while electronic cigarettes contain none of the above, other than the nicotine. It also omits mention of the fact that there are no hazardous chemicals that have been identified in electronic cigarette vapor at anything other than trace levels that are known to have significant adverse health effects.

In other words, the paper is ignoring the factor which is the overwhelming determinant of the relative safety of electronic cigarettes: the chemicals present in the inhaled vapor.

Instead, the paper focuses exclusively on one small aspect of the product's use: the puffing intensity.

While this would be fine if the paper simply kept to a discussion of puffing intensity, it fails to do that, as the abstract's discussion section goes so far as to argue that the increased puffing intensity of electronic cigarettes may make these products more harmful to users. Why draw conclusions that are pure speculation and are not supported by any evidence within the paper itself? This editorializing makes it appear that the paper has a pre-determined conclusion about the safety of electronic cigarettes.

Similarly, the paper concludes that electronic cigarettes are not a useful nicotine delivery device based solely on one factor - the lack of consistency in nicotine delivery - but ignoring the much more important evidence: whether the product has been found to be or not to be effective as used by actual human beings. Once again, the paper is drawing a conclusion that goes beyond the scope of the actual findings. This editorializing also makes it appear that the paper has a pre-determined conclusion about the effectiveness of electronic cigarettes.

While the paper's findings regarding the level of puffing intensity for electronic cigarettes compared to conventional cigarettes are interesting, they clearly do not support the type of sweeping assertions that the paper makes in postulating the implications of the study.