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US Surgeon General Critiqued

Posted 19th September 2017 by Dave Cross
A group of harm reduction experts have offered up a critique of the the previous US Surgeon General’s conclusions regarding e-cigarette use among youth and young adults in the United States of America. Riccardo Polosa, Christopher Russell, Joel Nitzkin and Konstantinos Farsalinos have submitted their study to Harm Reduction Journal.

The ex-official, Vivek Murthy, put his name to a piece of scare-mongering nonsense in the nation’s first surgeon general's report on e-cigarettes, last year. The Washington Examiner was probably being too polite when it termed his contribution to the global debate as promoting “e-cig hysteria”.

Murthy’s document was, in truth, penned by others with axes to grind. Its focal point was that vaping is “a major public health concern in the United States of America”. It was a statement so clearly, demonstrably ridiculous given the paucity of data to support any claims of danger or transition to smoking.

Murthy said: “These products are now the most commonly used form of tobacco among youth in the United States, surpassing conventional tobacco products, including cigarettes, cigars, chewing tobacco, and hookahs.”

The CDC’s director Thomas Frieden added: “[Ecig] companies are promoting their products through television and radio advertisements that use celebrities, sexual content, and claims of independence to glamorize these addictive products and make them appealing to young people.”

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Murthy’s report made no end of nonsense claims, such a vaping leading to brain damage – Clive Bates responded at the time: “If that is the case, where are the smokers with brain damage? On what basis is it possible to claim any material risk to bystanders from second-hand vapour exposure? The report treats vaping as if it is a new and additional phenomenon in isolation, rather than a young person might be benefiting from vaping instead of smoking. This, the surgeon general has crossed the boundary between science and propaganda.”

Polosa, Russell, Nitzkin, and Farsalinos went back to the report, pulled out all of the key data source references for nicotine toxicity and prevalence of youth use and subjected them to a re-analysis.

The team write: “The majority of the very small proportion of US youth who use e-cigarettes on a regular basis, consume nicotine-free products. The sharpest declines in US youth smoking rates have occurred as e-cigarettes have become increasingly available. Most of the evidence presented in the Surgeon General’s discussion of nicotine harm is not applicable to e-cigarette use, because it relies almost exclusively on exposure to nicotine in the cigarette smoke and not to nicotine present in e-cigarette aerosol emissions.”

They concluded that the U.S. Surgeon General’s claim that vaping is an emerging public health concern “does not appear to be supported by the best available evidence on the health risks of nicotine use and population survey data on prevalence of frequent e-cigarette use”.

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While agreeing that teen ecig use is something that must be constantly monitored, they point out: “Compared to conventional cigarettes, e-cigarettes substantially reduce the user’s exposure to harmful and potentially harmful constituents of tobacco smoke, and may have a reduced liability for abuse,” and that “e-cigarettes may have the potential to reduce the likelihood of smoking initiation among youth who may be especially at risk for initiating smoking in the absence of e-cigarettes”.


 Dave Cross
Article by Dave Cross
Freelance writer, salad destroyer and live culture convert.
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