A recent study, published at the end of last year (2021) has sparked another, in what has become a long history of bad press for vaping. This instance appears to have been the straw that broke the camel’s back for two experts – Caitlin Notley and Konstantinos Farsalinos, causing the two to speak out in The Independent against sensationalised headlines that harm the public’s perception of vaping.
Konstantinos is a research associate from the University of West Attica in Greece, whereas Notley is from the University of East Anglia’s Medical school where she is also a senior lecturer on mental health. The latter is actually the lead scientist behind the landmark NHS vaping trial currently underway in UK A&E departments, wherein patients who identify as smokers are being offered vaping starter packs rather than simply pointing them to the current stop smoking services.
Suffice to say Professor Notley is close to the vaping ‘issue’ and is clearly on the side of a growing number of healthcare experts, politicians and lobbyists who are calling for greater recognition of the increasing evidence in favour of vaping as a cessation tool. A movement that has gained unbelievable traction as the UK draws closer to its 2030 deadline for a smoke-free generation. We have already seen the evidence of this with UK manufacturers being asked to submit vaping devices for medical licencing at the end of 2021.
The Vaping Study Sparking Recent Bad Press
Notley and Farsalinos describe a particular study in their argument, which was published in Nature in November 2021. The study specifically looked at DNA damage caused by vaping, as compared to that caused by smoking. This DNA damage can leave people open to a higher risk of various diseases. The results published most prominently describe the fact that the changes to DNA in vapers was very similar to the changes observed in smokers.
Why Experts Say the Trial Falls Short
While the trial’s results are not inaccurate, Notley and Farsalinos have questioned the lack of “real-world” context given to the findings, which have left it wide open for misinterpretation by the public. A misinterpretation they feel is particularly exacerbated by the fact that most members of the public will encounter the results of such studies only when they are reported on by media outlets, which often sensationalise the results to encourage people to read their stories.
Various aspects of the study were scrutinised:
“The study recruited a relatively small number of people who were not representative of the population. And it did not consider other lifestyle habits that may affect the measurements, such as alcohol use.”
“Transcriptomics (the study of “gene readouts” in a cell), which this study used, is a promising field that explores the molecular mechanisms and potential processes leading to cancer. However, it cannot currently be used to accurately predict future cancer risk.”
They go on to acknowledge that the study does at east attempt to separate the effects of vaping from the effects of smoking, but owing to most vapers being ex-smokers, felt this was not an easy or practical thing to do. In fact, Notley notes that one of the most important differentiating factors was buried within the published scientific paper. This result found the damage to smokers’ DNA to be 7.4 times higher than the damage found in vapers.
They stressed that “crucially, this evidence was based on a few people by examining changes in their DNA at the time, similar to creating a snapshot, without considering any potential future change in vaping or smoking behaviour. The study does not provide real-world evidence of vaping-associated ill health.”
Misinterpretation of Vape Trials in the Media
Trials such as the one described above have raised experts’ concern owing to their lack of proper representation in the media. While their findings may not be false, a lack of context can cause people to get the wrong end of the stick very easily. This can lead to people making firm decisions without truly understanding all the data.
With the aforementioned DNA study in smokers and vapers as a recent example, Notley and Farsalinos have said, “Studies that do not examine direct clinical effects are easily interpreted and reported as evidence of health damage. A Daily Mail headline states: “Vaping damages DNA and raises the risk of cancer the same way as cigarettes, study claims”. Although the second part of the headline offers balance - “but it’s not as bad as traditional smoking”, the damage to public perceptions may already be done.”
“It is irresponsible to report sensationalist headlines based on complex studies that in reality do not show any real-world harm, particularly compared with the immense harm of tobacco-smoking.”
Vaping has already been the subject of a slew of negative coverage in the media, from exploding devices to harmful ingredients in e-liquids. These stories have made for dramatic headlines that are still used by many as a reason not to try vaping at all, whether or not they have been given proper context. For example, a number of the biggest and scariest vaping headlines in recent years have been exclusive to the US vaping market. The incidents referenced were uniquely able to occur there due to the very different rules America had in place to regulate its vaping market at the time.
The fact remains that the stricter rules enforced in the UK meant that similar incidents were highly unlikely, and the products most consumers here could buy were far safer than their overseas counterparts. Regardless, and due to the fact this difference was often excluded from reports in the media, many UK consumers still fear vaping as a result.
Public Misconception of Vaping
This public misconception is feared by experts like Notley, to be preventing vaping from reaching its full potential as a smoking cessation tool. They maintain that vaping should not be seen as a perfect solution, but that there is clear evidence in favour of its power to help smokers quit when combined with appropriate support.
Referring to the DNA study once again, Professor Notley states, “No one is claiming that e-cigarettes are completely risk-free. Inhaling anything may result in changes to DNA that could increase risks of disease. Inhaling fumes from diesel cars, for example, has been shown to cause DNA changes.”
“This study finds what we know already: vaping is not completely risk-free but is much less risky than smoking tobacco.”
She and Farsalinos highlight that while people can overcome nicotine dependence with basic support, many more find it a near-impossible challenge. It is in these cases that they feel Doctors must encourage smokers to at least find a way to use nicotine that causes less harm – be it through vaping or the use of Nicotine Replacement Therapy (NRT) products. They feel however, that information devoid of context will prevent many from giving them a try.
“For the public good, the focus should be on reducing harm, since preventing all harm is impossible.”
“Studies are already emerging showing that switching from smoking to e-cigarettes can have benefits such as improvement in respiratory symptoms and lung function in asthma patients or improvements in predictive measurements such as blood vessel function for cardiovascular disease.”
“Other studies show that exposure to toxins is far lower in vapers who used to smoke compared with current smokers. It is important to look at all the evidence, which supports the harm reduction role of e-cigarettes as a smoking substitute.”
Have you ever seen a dramatic headline that has made you think twice about vaping? You won’t be alone. With fair and impartial information it is far easier to decide whether or not vaping is right for you and your lifestyle. If you want to learn more about vaping and NRT products as smoking alternatives, you can check out our blog Finding the right alternative. If you’re already vaping but wonder how nicotine might be affecting your body, you can explore the facts in Nicotine and Health.