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Landscape Designers Corrected

Authors of “The Evolving Landscape of e-Cigarettes” have been corrected by expert and advocate Colin Mendelsohn

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“The Evolving Landscape of e-Cigarettes - A Systematic Review of Recent Evidence” was published in Thoracic Oncology CHEST Reviews. The authors relied on a myopic selection of studies to paint a picture of a post-apocalyptic landscape that would make a fitting home for Dark Lord Sauron in Lord Of The Rings. Experts Colin Mendelsohn and Wayne Hall have written to highlight several serious flaws in their work.

They cited studies by the likes of recently retracted Stanton Glantz, Lincolnshire’s foremost expert on the art of massage David Bareham, Jessica ‘I will ignore evidence for funding’ Barrington-Trimis, and Andy ‘won’t someone think of the children’ Leventhal.

The concluded: “The findings in this review established via in vitro, ex vivo, and animal models that e-cigarette exposure/use leads to distinct immunologic alterations that may contribute to an increased susceptibility to infection.”

They focus on the “toxicity of flavor additives”, that vaping eliquids “affect the cardiopulmonary system”, worrying about “increased BP, HR, and arterial stiffness” despite the fact that a cup of coffee or making love does the same thing and it’s a short-term impact.

In addition, much remains unknown about the effects of e-cigarette use, in particular in the long term, and there is evidence that smokers do not ‘quit’ with e-cigarettes but rather ‘switch’ to e-cigarette use.”

This “evidence” comes from research outcomes that Stanton Glantz invented.

Of great concern are the latest studies which show that dual use of e-cigarettes and tobacco cigarettes may put users at increased cardiovascular disease risk over smoking or e-cigarette use alone.”

This, again, is from Stanton Glantz. A study so flawed that even the highly supportive journal ended up pulling it due to Glantz’ academic malpractice.

It is significant that the bulk of the papers the team looked at ignored the wealth of quality work conducted in the United Kingdom. It’s impossible not to draw the conclusion that the reason for this is that it undermines almost every point the authors wished to make.

Experts Colin Mendelsohn and Wayne Hall wrote to Thoracic Oncology CHEST Reviews in response, offering up a number of comments and corrections.

The most relevant question for smokers is whether vaping nicotine is less harmful than smoking the cigarettes it is designed to replace. The evidence suggests it is far less harmful. The National Academies of Sciences, Engineering, and Medicine report found substantial evidence that ‘exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes’ and ‘reduced short-term adverse health outcomes in several organ systems’.”

Mendelsohn and Hall continued: “The authors quite rightly conclude that ‘e-cigarette use is not risk-free for non-smokers.’ However, international studies of adults and youth show that current use of e-cigarettes by never smokers is rare, and regular use is very rare, usually <0.5%.

Most of the research on the harms of e-cigarettes is from in vitro and animal studies. How these findings translate to health effects in humans is uncertain, when many human studies show substantial health improvements in smokers who switch to vaping.”

The recent outbreak of lung injuries in the United States electronic-cigarette, or vaping, product use-associated lung injury (EVALI) was not due to nicotine vaping. Most, if not all, cases were the result of vaping black-market tetrahydrocannabinol contaminated with vitamin E acetate. No cases have been associated with commercial nicotine vaping.”

They state that the authors’ claim that “we cannot exclude the possibility that ‘e-cigarettes pose a similar, lesser, or greater cancer risk than cigarette smoking’ because of the presence of carcinogens and potential adverse effects in two studies” is flawed because, “given the greatly reduced number of carcinogens and their lower concentration in e-cigarette vapor, it is very likely that the cancer risk from vaping is only a tiny fraction of the risk from smoking.”

Finally, Mendelsohn and Hall conclude, “the authors appear to misunderstand the role of tobacco harm reduction in questioning the value of vaping as a quitting aid when many ex-smokers continue to vape after quitting. Replacing a high-risk behaviour with a far less harmful one is a well-accepted public health strategy, for example, methadone maintenance for heroin addiction.

Evidence from randomized controlled trials, population studies, and better-quality observational studies shows that e-cigarettes are effective quitting aids. The authors are correct that short-term nicotine replacement therapy is less harmful than vaping, but it is also far less effective for quitting, and very few smokers use it.”

The authors responded to Mendelsohn and Hall. The reply demonstrated they weren’t interested in facts, balance, or evidence.


  • The Evolving Landscape of e-Cigarettes” by Bozier 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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