Adding to the long list of tobacco control practitioners who have publicly declared that smoking may be no more harmful than vaping - which involves no tobacco and no combustion - a South Carolina respiratory therapist is telling patients that they should not quit smoking using electronic cigarettes because these devices may be more dangerous than tobacco cigarettes, which kills more than 400,000 Americans each year.
On the Greenville Health System blog, a respiratory therapist writes: "I strongly oppose the use of e-cigarettes. It is unregulated and could potentially be more dangerous than a regular cigarette."
This respiratory therapist misleadingly reports that: "emergency rooms across the United States have been reporting visits
from patients that use e-cigarettes, with a variety of complaints,
including blood clots, difficulty breathing, coughing, headaches and chest pain." But he fails to also mention that emergency rooms across the nation have also been reporting visits from patients who use NRT, with a variety of complaints that include blood clots, difficulty breathing, coughing, headaches and chest pain.
Moreover, he fails to report that emergency rooms across the nation have also been reporting suicides and attempted suicides from the use of Chantix.
The Rest of the Story
This irresponsible advice, supported by a fraudulent lie - that smoking may be safer than vaping - represents public health malpractice, in my opinion. In fact, as it may convince some smokers to continue smoking rather than switch to a non-tobacco product that has helped thousands quit smoking, it could actually constitute medical malpractice, as this negligent information and advice could actually lead to medical harm.
Why is it negligent? Because it deviates from a well-accepted standard of care in medical and respiratory therapy practice, which is telling the truth. By disseminating false information - that smoking may be no more hazardous than vaping - to patients, this could lead to medical harm by convincing smokers not to quit via electronic cigarettes, but based on false information.
It is certainly not medical malpractice to advise patients not to use electronic cigarettes, because these products are not yet the standard of care in medical treatment for smoking dependence. However, to tell patients not to use electronic cigarettes because they may be more dangerous than cigarettes is clearly negligent, and in my opinion it rises to the level of malpractice if it ends up causing medical harm (i.e., a smoker who is misled by this advice and decides not to quit smoking because of the advice).
But beyond the issue of medical or public health malpractice, I am most concerned about the simple principle of honesty. As medical and health professionals, our very first obligation is to be truthful with our patients and with the public. The information being provided by this respiratory therapist is untruthful. It is simply not the case that smoking may be less hazardous than vaping. There is no credible scientific debate about that issue in the year 2014.