One of the most central tenets of medicine and public health is "to do no harm." Research out of the Center for Survey Research at the University of Massachusetts Boston suggests that many anti-smoking groups are violating this principle, causing tragic consequences by promoting smoking to a significant proportion of the population.
Yesterday, I discussed a study, just published online ahead of print in the journal Nicotine & Tobacco Research,
which reports the results of a population-based survey of smokers followed up
after two years to determine whether e-cigarette use was associated
with higher or lower rates of smoking cessation. The study found that intensive electronic cigarettes users at baseline were six times more likely to quit smoking after a two-year follow-up period compared to intermittent or non-users.
However, the survey included a very useful question for all smokers who had tried, intermittently used, or intensively used electronic cigarettes but discontinued e-cigarette use for some reason and returned to smoking. Specifically, these smokers were asked to name the most important reasons why they returned to cigarette smoking.
Sadly, the third most common reason given by smokers was concern over the health effects of electronic cigarettes. Nearly one-third (29.3%) of smokers who discontinued e-cigarette use and returned to exclusive smoking listed concern over the health effects of vaping as a very important reason for stopping e-cigarette use.
This is unfortunate because despite the propaganda being disseminated by many anti-smoking groups, vaping is much safer than smoking and there is no legitimate health concern that should lead a smoker to choose tobacco cigarettes over fake, tobacco-free ones.
I find it truly tragic that a substantial proportion of smokers who have used e-cigarettes - perhaps as many as one-third - have fallen for the propaganda of many anti-smoking groups and have discontinued their cessation or reduction attempts and returned to full-time cigarette smoking because of a concern about their health. This is completely irrational, as there is no question that switching to electronic cigarettes is much safer than continuing to smoke, and that even a major reduction in smoking has positive respiratory health consequences.
Where are these smokers getting the irrational and completely unfounded idea that a concern about their health should lead them to switch completely from vaping to smoking? The answer - and here is the sad part of the story - is that these smokers are almost certainly getting this false information from a host of supposedly "anti-smoking" groups which, as documented on The Rest of the Story over the past years, have been spreading false and misleading propaganda about the relative health effects of electronic cigarettes compared to tobacco cigarettes.
No later than yesterday did Stan Glantz again disseminate hysterical propaganda designed to scare people into thinking that the nicotine in electronic cigarettes causes heart attacks, despite the lack of any direct evidence that this is the case, and despite the fact that most scientists are unsure that the nicotine in cigarette smoke contributes to heart attacks. While Glantz provides the caveat that: "there are not yet direct evidence on the effects of e-cigarettes on the sympathetic nervous system," this is likely to be lost, given that the headline reads: "Reasons to worry about e-cig induced heart attacks."
I don't mean to single Stan out because he is joined by a host of supposedly "anti-smoking" groups. But the irony is that these groups, by disseminating propaganda that is demonstrably resulting in vapers deciding to switch completely back to smoking, are actually helping to promote cigarette smoking. Thus, it is uncomfortable to continue to refer to these organizations as "anti-smoking" groups. I do not question their intentions. However, when the effects of their actions are to promote smoking, then something is wrong.
And something needs to change. Right away.
Disclosure: I have not received any funding or compensation from
the tobacco, electronic cigarette, or pharmaceutical industries.
However, I am seeking funding from several electronic cigarette
companies to conduct a behavioral study on the effects of electronic
cigarettes on smoking behavior.