From it’s almost 600 pages, the document’s use can be possibly reduced to a single quote from the conclusion section: “e-cigarettes cannot be simply categorised as either beneficial or harmful to health”. While this may be a trite statement to make, isn’t it woeful that self-proclaimed experts can’t climb down on one side of the fence?
The authors explain their position: “The net public health outcome depends on the balance between adverse outcomes (increased youth initiation of combustible tobacco cigarettes, low or even decreased cessation rates in adults, and a high-risk profile) and positive outcomes (very low youth initiation, high cessation rates in adults, and a low-risk profile).”
To a greater extent, it displays a lack of conviction to follow the evidence and a fear of upsetting those who pay the bills in academia and provide incentives to those working in medicine. Why else would more space be given to unfounded fear-mongering rather that detailing the verified genuine science? It all relies too heavily on the ‘we don’t know enough about it’ mantra, practised by anti-ecig campaigners.
They continue with the negative skew: “In some circumstances, adverse effects of e-cigarettes clearly warrant concern, such as the use of e-cigarettes among non-smoking adolescents and young adults, devices that are prone to explosion, and the presence of constituents in e-cigarette liquids that are of major health concern (e.g., diacetyl and some other flavourings).”
The reports lists out “a number of federal regulatory tools”, that “exist to maximise the benefits and minimise the harms of e-cigarettes,” before going on to lump vaping into the same bracket as the new heat-not-burn products (even though only one of them uses tobacco).
Then, without any substantial reason, the report conclusion ends with reference to vaping being used as a way of enjoying cannabis – a substance now legal in many States.
For all of the negative aspects, the report does contain some positive highlights. The authors make repeated reference to “conclusive evidence” that “completely substituting e-cigarettes for combustible tobacco cigarettes reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes.”
Readers of Vox magazine are led to believe the report has four main points:
- That evidence for efficacy is not there
- That young vapers will go on to smoke
- That vaping carries less harm
- That vaping might be dangerous
Vox calls NASEM a “prestigious organisation”, but it is worth remembering that Sourcewatch noted from a survey: “almost one in five scientists appointed to a [NASEM] panel, had direct financial ties to companies or industry groups with direct stakes in the outcome.”
Slightly more detailed coverage comes from the AAFP, although it buys in to the fear of a new generation of nicotine addicts, rooted in an association between nicotine and tobacco illness. At some point America needs to grow up and have a more adult conversation about vaping as it is for substance use.