Portland State E-Cigarette Claims Debunked in the New York Times

New York Times op ed columnist Joe Nocera today knocks Portland State University researchers’ claims that e-cigarettes produce higher levels of formaldehyde than cigarettes (here) – bogus findings that I slammed last week (here).

Lead author of the research paper, Dr. David Peyton, told Nocera that his study had been mischaracterized: “It is exceedingly frustrating to me that we are being associated with saying that e-cigarettes are more dangerous than cigarettes. That fact is not in evidence.”

What is not in evidence is the researchers’ credibility.  On January 22, Dr. Peyton was quoted in his university’s press release: “Our research shows that when heated at higher temperatures, e-cigarette juices can vaporize and form large amounts of ‘hidden formaldehyde,’ five to 15 times higher than the amount of formaldehyde in traditional cigarettes (here)”

Kudos to columnist Nocera.

Bogus Research on Formaldehyde in E-Cig Vapor

The New England Journal of Medicine yesterday published a letter claiming that vapor contains “hidden” formaldehyde at far higher levels than cigarettes (here), which made headlines worldwide.  That conflicts with a report I discussed last week, documenting that formaldehyde levels in e-cigarettes were far lower than those in traditional cigarettes (here).

R. Paul Jensen and colleagues at Portland State University produced the new results by overheating an e-cigarette, a condition (called dry puffing) that is familiar to vapers; the resulting product tastes so bad it cannot be inhaled.  In other words, the formaldehyde produced under abusive conditions is not “hidden” at all, because it is in vapor that users find intolerable.

Dr. Konstantinos Farsalinos, a cardiologist at the University of Patras in Greece and a recognized expert in vapor devices, has documented that the formaldehyde findings are bogus: “Lack of experience on e-cigarettes and no contact with vapers can result in such erroneous and unrealistic results, which can create confusion and misinformation both in the scientific community and among users and potential users of e-cigarettes… The authors of the NEJM study should have read our study and should have known about the existence of this phenomenon.” (here).

One of the new study’s authors, James Pankow, has published other scaremongering reports.  In 2010, he claimed that wintergreen flavor in smokeless tobacco is dangerous (here) and he coauthored a largely theoretical study claiming that “infants and children are particularly at risk” from thirdhand smoke. (here).

Modern automobiles have remarkably low pollutant emissions, but anyone behind a car that is overheating or otherwise abused can smell noxious fumes as they are released.  Using the New England Journal of Medicine, Jensen and colleagues have created global headlines with a defective e-cigarette experiment, producing scientific pollution.

Formaldehype vs. Fact: Levels Are Far Lower in E-Cigarettes Than In Cigarettes

Researcher Naoki Kunugita at Japan’s National Institute of Public Health recently fueled anti-e-cig hysteria with this unverifiable claim: “In one brand of e-cigarette the team found more than 10 times the level of carcinogens contained in one regular cigarette.”

The charge came not in a peer-reviewed study, but in comments to the press publicizing favorable e-cig research.  His group looked at 13 Japanese e-cigs and reported in the International Journal of Environmental Research and Public Health that they had lower levels of formaldehyde than cigarettes (here).

Formaldehyde is everywhere, even in the air we breathe.  Individuals inhale about 1,000 micrograms per day, according to the World Health Organization (here), and a microgram is a very small amount – one-millionth of a gram.

The Japanese researchers collected from 0 to 34 micrograms from 10 puffs of e-cigarettes – at most, about one thirtieth of normal daily exposure from air.  In contrast, 10 puffs of a cigarette deliver 150 to 200 micrograms.

Apparently, after the controlled research was completed, Kunugita recorded 1,600 micrograms (10 times the cigarette level) using another e-cig brand.  That single observation generated the worldwide headlines.  Not only is the finding completely out of range with respect to all other studies, the claim is unverifiable. 

Publishing a scientific report showing low formaldehyde levels and then publicizing an unsubstantiated claim of 10-fold carcinogenicity is irresponsible.  The announcement was rightfully condemned by e-cigarette expert Konstantinos Farsilanos in his research blog (here).

The unvalidated claim undercuts legitimate science and sends smokers a horrific message: keep lighting up, because e-cigarettes are more dangerous. 

E-Cigarette Denial: It Just Doesn’t Work Anymore

Recently I attended a forum on e-cigarettes, sponsored by a political organization that wanted to educate its attendees about the devices.  During the discussion my opponent [from the prohibitionist American Legacy Foundation] repeated the baseless claim that there is no evidence that e-cigarettes help smokers quit. 

I responded that there is clear evidence: several clinical studies demonstrate that e-cigs work – previously discussed in my blog (here, here, here and here).

The clinical trial evidence has reached a sufficient size that a meta-analysis has been conducted.  Circulation, the flagship journal of the American Heart Association, contained the abstract of such a review presented (here) by University of Melbourne (Australia) investigators at a recent meeting.  They found that “Use of…e-cigarettes was positively associated with smoking cessation …Nicotine filled e-cigarettes were more effective in achieving cessation compared to those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Use of e-cigarettes was also effective in reducing smokers’ daily cigarette consumption…In conclusion, available literature suggests that the use of e-cigarettes may be an effective alternate smoking cessation method.”

After my response one of the attendees at our forum stated that he had quit smoking using e-cigs, and he had also convinced two of his relatives to quit.  As he noted, “it may not be a clinical trial, but it is real evidence.”

This doesn’t happen just at every event I attend.  It happens at virtually every conversation I have.  Almost everybody now knows former smokers who credit e-cigarettes with life- and breath-saving benefits.  The Consumer Advocates for Smoke-Free Alternatives Association maintains a webpage linking to over 2,000 testimonials from successful switchers (here).    

Cartoonist Bill Watterson said: “It's not denial. I'm just selective about the reality I accept.”  Anti-tobacco zealots who refuse to acknowledge the new reality of e-cigarettes also qualify for membership in The Flat Earth Society (join here).