An anti-vaping researcher, citing findings solely from an in-vitro cell culture study without clear clinical significance, has claimed that vaping can cause fatal respiratory infections. Based on his extrapolation from an in-vitro study to human disease, this researcher has advised all vapers to be vaccinated for serious bacterial lung infections. However, at the same time, he failed to advise smokers to be vaccinated against these same serious infections.
According to an article in the Times of London, a professor of pediatric respiratory and environmental
medicine at Queen Mary University of London "has found that the chemical propellants and nicotine used in ecigarettes both have a powerful
effect on lung cells,effectively opening them up to infection by the
bacteria that cause pneumonia." Based on this finding, he has warned that "Vaping may raise people’s risk of pneumonia and other
deadly bacterial infections."
Despite the fact that these findings related only to a cell culture and cannot be extrapolated to living humans, the researcher nevertheless recommended that "People who vape should consider vaccination
against bacterial pneumonia." The researcher did not make a similar recommendation for smokers.
The researcher presented these results at the annual meeting of the European Respiratory Society, although they have not yet been published in a medical journal.
The Rest of the Story
Lipinski and Hopkins explained that the findings of in vitro (or ex vivo, as in this case) study cannot be extrapolated to have clinical significance in humans: "Whether the aim is to discover drugs or to gain knowledge of biological
systems, the nature and properties of a chemical tool cannot be
considered independently of the system it is to be tested in. Compounds
that bind to isolated recombinant proteins are one thing; chemical tools
that can perturb cell function another; and pharmacological agents that
can be tolerated by a live organism and perturb its systems are yet
another. If it were simple to ascertain the properties required to
develop a lead discovered in vitro to one that is active in vivo, drug discovery would be as reliable as drug manufacturing."
Extrapolating from in vitro studies to humans can actually be quite dangerous. For example, anthrax was not found to cause problems when derived in vitro, but the same extract derived from living animals was highly toxic.
Clinical experience actually suggests that switching from smoking to vaping decreases the risk of pneumonia and severe lung infection and does not support the contention that vaping significantly increases the risk of fatal lung infections. Despite the millions of people using electronic cigarettes, including many nonsmokers, I am not aware of a single case of a fatal lung infection attributable to vaping.
Therefore, the advice being given by this researcher is negligent. It is negligent not only because there is as yet no evidence supporting a clinical indication for vaccination among people who vape, but also because he fails to recommend vaccination among smokers, who in many cases are at increased risk of serious respiratory infections.
Many people reading this article might conclude that vaping is more dangerous than smoking, since vaccination is only recommended for vaping, but not for smoking. What the researcher has done here in misleadingly communicating the implications of his research is, in my view, negligent because it is unsupported by credible scientific evidence, contradicted by clinical experience, and damaging to the public health.
To make matters worse, that smokers are at risk of serious respiratory infections and in some cases should be vaccinated is not the only thing that the researcher hides from the public in this article. He also hides his financial conflict of interest with Big Pharma, and specifically, with GlaxoSmithKline, a company which stands to lose financially if electronic cigarettes become increasingly popular, as they are a competitor to Glaxo's nicotine gum, lozenges, and patches. The researcher has apparently served as a paid consultant for GlaxoSmithKline, a fact that is not revealed in the newspaper article, thus hiding from readers knowledge of this important conflict of interest which has the appearance of biasing the researcher's reporting of the significance of his study findings.
And to add insult to the injury done by this misleading communication of scientific findings, the European Respiratory Society annual meeting itself is financially conflicted, since it received support from Big Pharma, including Pfizer, GlaxoSmithKline, Novartis, CSL Behring, Hoffman LaRoche, Astra Zeneca, Pneum-Rx, Bayer, Merck, and many more.
This story encompasses the conglomeration of what is wrong with the reporting of science in the area of tobacco control today.