Dr. Michael Blaha, Director of Clinical Research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, has published an article titled, “5 Vaping Facts You Need to Know.” The piece contains a number of glaring falsehoods.
I should note my profound disappointment with this article, as Dr. Blaha recently joined me and Sally Satel as faculty members of the since-cancelled Medscape medical education course on tobacco harm reduction (THR). Despite Dr. Blaha’s involvement with the tobacco-prohibitionist American Heart Association, I appreciated his cooperative attitude and moderate opinions. The shortcomings of his subsequent article are all the more disappointing.
Here are highlights from Dr. Blaha’s piece, followed by my corrections.
1. “Vaping is less harmful than smoking, but it’s still not safe.”
While
Dr. Blaha acknowledges “that vaping exposes you to fewer toxic chemicals than
smoking traditional cigarettes,” he follows with five paragraphs on the CDC-labeled
subject of e-cigarette or vaping use-associated lung injury (EVALI). This is grossly misleading, as the cause of EVALI was identified
years ago as illicit marijuana
2. “Research suggests vaping is bad for your heart and lungs.”
Dr.
Blaha states what every health professional should know: Nicotine is addictive,
and it “raises
your blood pressure and spikes your adrenaline, which increases your heart
rate…” But he doesn’t include the
critical phrase, “transiently, while you’re using it.” He then cites studies claiming associations
of vaping and lung/heart diseases, most of which have been demonstrated by my
research team as unreliable or bogus (here, here and here)
3. “Electronic cigarettes are just as addictive as traditional ones.”
Here Dr. Blaha ignores the fact that nicotine is no more harmful than caffeine, which is also addictive. Further, he claims, “many e-cigarette users get even more nicotine than they would from a combustible tobacco product: Users can buy extra-strength cartridges, which have a higher concentration of nicotine, or increase the e-cigarette’s voltage to get a greater hit of the substance.” This is irrelevant, as all tobacco users titrate their dose for satisfaction and enjoyment.
4. “Electronic cigarettes aren’t the best smoking cessation tool.”
This is false. Population evidence that smokers are switching has been ignored for years by federal officials and others (here and here). I disagree with Dr. Blaha about the need for consumer vaping products to be proven in clinical trials (here), but two smoking cessation trials, published in the New England Journal of Medicine in 2019 and 2024, clearly demonstrate that vapor products outperformed Dr. Blaha’s preferred “FDA-approved smoking cessation options.”
5. “A new generation is getting hooked on nicotine.”
This is another falsehood. I have demonstrated that only a tiny fraction of high school vapers are at risk of nicotine addiction and have not used other tobacco products (here).
6. “Getting hooked on nicotine often leads to using traditional tobacco products down the road.”
No. Federal surveys show that the minuscule smoking rates among high schoolers is being maintained by young adults (here).
One could surmise from Dr. Blaha’s concerns about why e-cigarettes are attractive to young people that the following steps should be taken:
· Because many teens believe vaping is less harmful than smoking, we should lie to them.
· Since e-cigarettes have a lower cost-per-use than traditional cigarettes, we should raise prices.
· As e-cigarettes have no smell, thereby reducing the stigma of using tobacco, we should make them stink.
None of the above make sense, as all the facts about vaping show there is no youth vaping crisis to fix.
President-elect Donald Trump has nominated Dr. Blaha’s Johns Hopkins colleague Dr. Marty Makary to be FDA Commissioner. I hope Dr. Blaha’s article isn’t his application to be Director of the FDA Center for Tobacco Products.
