Friday, December 11, 2009

Action on Smoking and Health Claims that "Secondhand" Electronic Cigarette Vapor Causes Heart Attacks in Bystanders

Action on Smoking and Health (ASH) is claiming that the vapor exhaled by electronic cigarette users causes heart attacks in nonsmokers because of the nicotine exposure it creates among these bystanders.

In a press release issued yesterday and entitled "NJ Poised to Ban E-Cigarettes in Public // Second State to Protect Bystanders From Heart Attacks," ASH wrote: "New Jersey is poised to become the second state to ban the use of e-cigarettes [e-cigs] in public places where smoking is already prohibited, with the New Jersey Senate set to vote today on a bill already passed unanimously by the Assembly. A primary purpose, says Action on Smoking and Health (ASH), the antismoking organization which supplied a detailed report supporting the bill, is to protect bystanders who otherwise are at possible risk from heart attacks, just like those inhaling secondhand tobacco smoke. ... As many studies have found, exposure to even small amounts of drifting tobacco smoke can trigger a heart attack in nonsmokers in as little as 30 minutes. Since a major cause of the heart attacks is nicotine, the main component of the vapor exhaled by e-cig users, those in the vicinity of e-smokers appear to be at similar risk."

The Rest of the Story

The claim being made by ASH is completely unsupported by scientific evidence. There simply is no scientific evidence to support the assertion that secondhand vapor from electronic cigarettes is a cause of heart attacks in nonsmokers.

Not only is the claim unsupported by any evidence, but there is not any existing evidence that several necessary facts asserted by ASH are true.

First, in order for secondhand vapor to cause heart attacks in nonsmoking bystanders, the exhaled vapor would have to contain appreciable amounts of nicotine. There is no evidence that the exhaled vapor contains any significant amount of nicotine. The lungs are fantastic at extracting nicotine (this is why cigarettes are such an effective nicotine delivery device). We know that in the exhaled smoke from smokers, the level of nicotine is extremely low. Secondhand smoke itself does not expose nonsmokers to high levels of nicotine.

Second, in order for secondhand vapor to cause heart attacks, the exposure to nicotine among nonsmokers would have to be significant. Even if the vapor contained nicotine, it would be highly diluted by the time it reached the nonsmoker. The vapor dissipates almost instantly, and there is no evidence that there is any meaningful exposure to nicotine among nonsmoking bystanders.

Third, in order to conclude that secondhand vapor causes heart attacks, brief nicotine exposure would have to be shown to be a cause of heart attacks in nonsmokers. There is no evidence that this is the case. The platelet aggregating effects of tobacco smoke are apparently due to the combination of many particulate components of the smoke. There is no evidence that nicotine in isolation causes the effects that would be expected to trigger a heart attack.

The rest of the story is that ASH is making a health claim that is completely unwarranted, unjustified, and unsupported by the scientific evidence. It is literally a hysterical claim that has no basis whatsoever in science and is apparently based entirely in advocacy.

By making such a claim, ASH is putting the reputation of the entire anti-smoking movement at risk. It's like the boy who cried wolf. If the public sees that this claim is hysterical and pure hype, then what is going to prevent the public from having the same reaction when anti-smoking groups deliver accurate information that we really need the public to accept (such as the dangers of exposing children to secondhand smoke).

This unscientific hysteria threatens the scientific credibility of the entire tobacco control movement.

I believe it is the responsibility of all anti-smoking groups to speak out against this inappropriate tactic, and publicly refute the claim that ASH is making. By being silent, anti-smoking groups are actually complicit in the deception of the public.

Unfortunately, other than groups like ACSH and Smokefree Pennsylvania, none of the anti-smoking groups will speak out. Why? Because criticism is simply not acceptable in the movement and because the scientific integrity of the movement has deteriorated to the point where accurate science is no longer important. Nobody really cares because it is the agenda that is now driving the science, not the science that is driving the agenda.

So I feel confident in putting up a $100 offer to the first anti-smoking group (other than ACSH or Smokefree Pennsylvania) which publicly refutes the claim that Action on Smoking and Health is making. There is no way that I am going to have to pay up because these groups simply do not care about the actual science anymore.

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