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Scaremongering Called Out

38 tobacco harm reduction experts have written to The Lancet, calling out inaccuracies and misinformation The Lancet wrote in an editorial about vaping

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The Lancet published an editorial attacking vaping which included multiple examples of errors and misdirection. Thirty-eight harm reduction experts have submitted a response calling out the inaccuracies and misinformation and calling for a more dispassionate approach to the science surrounding electronic cigarettes.

Last October, The Lancet carried an editorial titled, “E-cigarettes: time to realign our approach?” It focussed on 1080 lung injuries and 18 deaths, attributing it all to vaping, because “all report[ed] using e-cigarettes”.

The anonymous author or authors claimed, “e-cigarettes have an uncertain provenance, containing a mix of ingredients,” and even stretched to asking, “how different are e-cigarettes from combustible cigarettes?”

The editorial claimed the blame did not lie with vitamin E acetate in e-cigarette liquid, rather that “the features were more consistent with airway-centred chemical pneumonitis from inhaled toxic substances.”

It said that claims vaping is safer than smoking and works as a quit smoking tool were “weak”, and that “no solid evidence base underpins the marketing claims that e-cigarettes are healthier than cigarettes or that they can support quitting”.

Laughably, the piece even claimed vaping was inspiring a “renormalisation of smoking”. It concluded: “Surely it is time to align the public health approach to e-cigarettes with that of cigarettes.”

The letter has just been published by The Lancet. Those who have added their names include:

  • David B Abrams, PhD Professor of Social and Behavioral Sciences; New York University, USA
  • Paul Aveyard, PhD MBBS Professor of Behavioural Medicine; University of Oxford, UK
  • Linda Bauld, PhD Bruce and John Usher Professor of Public Health; University of Edinburgh, UK
  • Emma Beard, PhD Senior Research Associate; University College London, UK
  • Neal Benowitz, MD Professor Emeritus of Medicine; University of California – San Francisco, USA
  • Ron Borland, PhD Professor of Psychology – Health Behaviour; University of Melbourne, Australia
  • John Britton, MD Professor of Epidemiology; University of Nottingham, UK
  • Leonie Brose, PhD Senior Lecturer; King’s College London, UK
  • Jamie Brown, PhD CRUK Professorial Research Fellow; University College London, UK
  • Chris Bullen, PhD MBChB Professor of Public Health; University of Auckland, New Zealand
  • Bertrand Dautzenberg, MD Professor of Pneumology and Tobacco Addiction; Hôpitaux Universitaires Pitié Salpêtrière Paris, France
  • Jean-Francois Etter, PhD Professor of Public Health; University of Geneva, Switzerland
  • Geoffrey T Fong, PhD Professor of Psychology and Public Health and Health Systems; University of Waterloo, Canada
  • Jonathan Foulds, PhD Public Health Sciences and Psychiatry; Penn State University, USA
  • Maciej L Goniewicz, PhD PharmD, Associate Professor of Oncology; Roswell Park Cancer Institute, USA
  • Peter Hajek, PhD Professor of Clinical Psychology; Queen Mary University London, UK
  • Sara Hitchman, PhD Lecturer in Addictions; King’s College London, UK
  • Sarah Jackson, PhD Senior Research Associate; University College London, UK
  • Martin J Jarvis, DSc Professor Emeritus of Health Psychology; University College London, UK
  • Daniel Kotz, PhD Professor of General Practice; University of Duesseldorf, Germany
  • Eva Kralikova, PhD MD Professor; Charles University of Prague, Czech Republic
  • David Levy, PhD Professor of Oncology; Georgetown University, USA
  • Ann McNeill, PhD Professor of Tobacco Addiction; King’s College London, UK
  • Hayden McRobbie, PhD MBChB Professor; University of New South Wales, Australia
  • Graham Moore, PhD Reader; University of Cardiff, UK
  • Marcus R Munafo, PhD Professor of Biological Psychology; University of Bristol, UIK
  • Raymond S Niaura, PhD Professor of Social and Behavioral Sciences; New York
  • University, USA
  • Debbie Robson, PhD RMN Senior Research Fellow in Tobacco Addiction; King’s College London, UK
  • Nancy Rigotti, MD Professor of Medicine; Harvard Medical School, USA
  • Lion Shahab, PhD Associate Professor of Health Psychology; University College London, UK
  • Natalie Walker, PhD DPH Associate Professor; University of Auckland, New Zealand
  • Kenneth E Warner, PhD Avedis Donabedian Distinguished University Professor Emeritus of Public Health; University of Michigan, USA
  • Robert J West, PhD Professor of Health Psychology; University College London, UK

The signatories say: “The inaccuracies and misinformation in the Editorial about e-cigarettes do a major disservice to evidence-based public health.”

“The latest evidence from the USA indicates that the outbreak of acute lung injury is strongly linked to the vaping of contaminated illicit marijuana products. Although a small minority of affected individuals had not reported using cartridges containing cannabis oil, it is possible that they did not wish to reveal such information or had been using other illicit contaminated products. The outbreak appears to be limited to North America where, and unlike the EU including the UK, vaping products are relatively free from regulatory oversight. The EU also imposes strict marketing controls on e-cigarettes, which perhaps explains why uptake of regular vaping (as opposed to experimentation) by youth younger than 18 years in the UK is low, confined predominantly to smokers, and is accompanied by a continuing decline in youth smoking to record low levels.”

“Equating the dangers of vaping with those of smoking ignores dozens of studies that show substantial differences in the risks associated with cigarette and e-cigarette use. The evidence of efficacy of e-cigarettes in helping smokers quit is not weak; the results of a randomised controlled trial5 have shown two times higher quit rates by people using e-cigarettes than in people using medicinal nicotine replacement therapy, confirming similar findings from population data. E-cigarettes have an important role to play in preventing death and disability from tobacco use, and, while remaining vigilant over potential adverse effects is vital, the effect on public health of denying smokers the choice to use e-cigarettes could be devastating.”

Will The Lancet and those contributing to the editorial cease scaremongering and look at science dispassionately?


  • “E-cigarettes: time to realign our approach?”, The Lancet editorial – [link]
  • “The need for an evidence-based and rational debate on e-cigarettes”, Shahab et al. – [link]

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Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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