Fact check. Don’t believe everything you hear in the media!
Posted on December 2, 2018
Maurice Swanson, CEO of the Australian Council on Smoking and Health (ACOSH) was interviewed today on radio 6PR about vaping, following an interview with Associate Professor Colin Mendelsohn, whom he repeatedly called 'Mr Mendelsohn'. ATHRA 'fact-checked' some of the statements made by Mr Swanson. We found that many statements were misleading and did not accurately reflect the best available evidence.
'The evidence so far show that most people who vape to give up don't quit in large numbers'
Really? Very large numbers of smokers have reported quitting with vaping in large national surveys, such as 6.1 million in the European Union, 3.2 million in the United States and 2.8 million in England.
'Most continue vaping or dual use'
Not true. Research indicates that about HALF of current vapers are not currently smoking (ie are not dual using). For example:
- United Kingdom: 55% of vaper have quit smoking and the proportion is increasing. In 2014, the figure was 40%
- United States: 45% of vapers do not smoke
- Iceland: 60% of vapers do not smoke
- New Zealand: 77% of vapers do not smoke
- Greece: 73% of vapers do not smoke
- Canada: 37% of vapers do not smoke
Furthermore, many vapers have gone on to quit BOTH smoking and vaping. In the UK alone, 770,000 have done so according to Public Health England.
'Dual users do not significantly reduce risk'
During dual use, smokers almost always reduce their cigarette intake, often to very low levels. This is because they get some nicotine from vaping and puff less on cigarettes. As a result, most studies have shown that dual users reduce their intake of toxins and carcinogens (here and here).
In any case, dual use is a transition stage for many. Long-term dual users are more likely to try to quit smoking and to succeed in quitting. Over a 12 month period Etter found that 46% of 367 dual users had quit smoking. It takes some time to adjust to vaping and gradually let go of the familiar smoking ritual.
'Vaping is likely to be less risky than smoking'
This statement is very misleading and does not reflect the huge risk differential between smoking and vaping. All credible scientists are very clear that long-term vaping is highly likely to be far less harmful than smoking. For example:
‘the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco’
The English government health agency agrees with the 95% safer figure, based on the following analysis:
‘the constituents of cigarette smoke that harm health – including carcinogens – are either absent in e-cigarette vapour or, if present, they are mostly at levels much below 5% of smoking doses (mostly below 1% and far below safety limits for occupational exposure)’
Director of the US FDA, Dr Scott Gottlieb
'If we can migrate every adult smoker completely on to an e-cigarette, it will have a profound public health impact. E-cigarettes are not risk free, but they are certainly safer than combustion. I think we can all accept that.'
The overall cancer risk from long-term vaping has been estimated at less than 0.5% of the risk from smoking. There is also a dramatic reduction in exposure to carcinogens and toxins (biomarkers) measured in the blood and urine of vapers compared to tobacco smokers.
The small health risks from vaping should be compared to the substantial risks from smoking. Two out of three long-term smokers will die from a smoking-related disease.
'The ATHRA website has only 4 so-called medical organisations that support vaping'
Actually, there are 33 Australian and international health and medical organisations listed on the ATHRA website here that support vaping.
'The latest results from the FDA is a catastrophe'
Mr Swanson refers to the fact that there has been a reported 78% increase in vaping by high school students (14-18 years old) in the US from 2017-2018, which he says is 'a public health tragedy'.
The National Youth Tobacco Survey (NYTS) did find a 78% increase in past 30-day vaping from 11.7% in 2017 to 20.6% in 2018. However, most of this increase was experimental and occasional vaping which presents little risk to health.
Only 5.8% of high school students in 2018 were regular vapers (≥20days per month). The vast majority of regular vapers are already smokers, so any additional risk to health from vaping is likely to be minimal.
Most importantly however, smoking rates in adolescents are plummeting in the US. Since 2014 when vaping became widespread, smoking rates in adolescents have fallen three times faster than the long-term trend prior to that.
The most plausible explanation for this unprecedented drop in smoking rates is substitution by vaping.
The following graph of NYTS data shows the rise in vaping in US youth (blue) coinciding with a dramatic decline in smoking (orange).
The primary concern of public health is the youth and adult SMOKING rates. A rise in youth vaping is not desirable, but is a far safer alternative to smoking. This is a public health success story!
The use of alcohol and cannabis among youth in the US is MUCH higher than vaping rates.
Mr Swanson may like to read Clive Bates excellent analysis of this here.
'The role of Big Tobacco'
Mr Swanson used the Big Tobacco bogey to reject vaping on the basis that anything that Big Tobacco does must be evil and therefore rejected. Big Tobacco has a wicked and dishonest past. But what if Big Tobacco switched from making lethal combustible tobacco products to safer nicotine products like vapes, surely that is a win for public health?
'ATHRA takes funding from Big Tobacco'
When all else fails, some vaping opponents play the man in an attempt to discredit the opposition. This criticism was answered in this recent ATHRA blog, by Dr Joe Kosterich.
The Cancer Council receives funding from Coles which is Australia's largest tobacco retailer. Is the Cancer Council therefore compromised?
'Just an anecdote'
Vapers hate this one. Sharon called in to tell her story on air. After 45 years of smoking, she finally quit by vaping and is slowly weaning herself off vaping. She described how she felt fantastic, has phenomenal cost savings, a reduced cough, no more smell, no stress about where she can smoke, happy it is 95% safer than smoking etc.
Mr Swanson's response: This is the experience of just one person and cannot be used by governments for policy change.
It is true that policy cannot be based on one story, but millions of stories should have some influence. How long can we continue to dismiss the lived experience of real people?
In the meanwhile, sorry Sharon, but you will need to go back to smoking. You and the many millions of other vapers have quit the WRONG way.
Invitation to Mr Swanson
All of this leads to the pertinent question - what drives this strident opposition to a far less harmful substitute for combustible tobacco? ATHRA and ACOSH share the same objective of reducing smoking-related death and disease as soon as possible and are in 99% agreement on how to do this.
We invite Mr Swanson to meet members of the ATHRA Board to discuss the evidence and work together towards our common goal.
Posted by Colin Mendelsohn, email@example.com