Medical organizations continue to
flood the media with false claims about e-cigarettes. Subsequent to the AMA
president’s January screed (here), the organization released a lengthy
scare
piece, extracted below with my comments in red.
______________________________
By Sara Berg, MS , News Editor
May 30, 2025 | 8 Min Read
AMA News Wire
What doctors wish
patients knew about e-cigarettes
May 29, 2025
Clouds of vapor, sweetened with the scent of candy or mint,
drift through the air. But behind the flavored haze, hidden dangers linger.
E-cigarettes, once marketed as a safer alternative to smoking, have found a
stronghold among teens and adults alike.
“Hidden dangers linger” falsely implies that the
article will expose them.
Yet physicians are sounding the alarm: vaping is far from
harmless. What many patients don't realize is that even without the tar and
smoke of traditional cigarettes, e-cigarettes carry serious risks to lung
health, heart function and even brain development.
Experts are sounding the alarm that the claims of e-cigarette
serious risks are devoid of evidence.
While vape use went down between 2023 and 2024, for the
11th year in a row, e-cigarettes have been the most commonly used tobacco
product among middle- and high-school students. In 2024, about 2.25 million
middle- and high-school students in the U.S. used at least one tobacco product,
according to the Centers
for Disease Control and Prevention.
This is confusing.
If the writer claims that “vape use went down” for 11 years in a row, it’s
not true. As the chart shows, vape use
by Americans is booming. In 2023 43% of
vapers were former smokers. All of this
progress, despite false alarms by the AMA and their prohibitionist allies.
High school vaping took a 64% nose dive from its peak
in 2019 until 2023 (here), but the
prohibitionists want the public to believe that a crisis persists.
This is alarming because tobacco use during adolescence
increases the risk of lifelong nicotine addiction and adverse health outcomes.
That is why the AMA adopted policy [sic] to decrease youth access to
e-cigarettes.
The AMA does not, in fact, believe that nicotine
addiction must be lifelong. It tells smokers
to quit with FDA-approved nicotine gum, patches and behavioral tips, which
works for about 7% of them.
The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they
want patients to understand about today’s health care headlines.
In this installment, Bilal Shahid Bangash, MD, a pulmonologist and critical care physician at Bayhealth,
discusses what patients should know about vaping or e-cigarettes.
Dr. Bangash’s credibility as a vaping authority is
questionable, as there is no record in PubMed of his having published anything.
Chemicals are also
found in vapes
“These devices contain other chemicals in addition to nicotine.
One of the most common ingredients is a chemical called propylene glycol, which
is a common additive in food,” said Dr. Bangash, noting “it may also be used to
make antifreeze, paint, solvents and artificial smoke.
Propylene glycol is so safe that it is routinely used
in a large number of foods, and in topical, oral, inhaled and injected
medicines (here). It has been used as artificial smoke and in airplane
antifreeze solutions, again, because it is nontoxic. It is a solvent, but that only means that it
mixes with water and a many other chemicals that make up everything we consume.
“Additionally, there are flavoring and other unknown
chemicals and ingredients,” he added, noting “it is believed when the liquid
heats up, it produces further toxic chemical release.”
This is true but misleading. Flavors and other vapor ingredients are
present in minuscule quantities that are at vastly lower levels than the 7,000
chemicals formed when tobacco is burned.
Vaping affects your
health
“There’s already proven evidence that youth or adolescents
who use e-cigarettes are at an increased risk of short-term lung disease,” Dr.
Bangash said. “Those patients who have asthma or chronic obstructive pulmonary
disease may experience increased coughing, wheezing and flare-ups.”
This is a non sequitur, as Dr. Bangash fails to define
“short-term lung disease” and then discusses “asthma or chronic obstructive
pulmonary disease,” which aren’t short-term.
Also, there is no “proven evidence” that vaping leads to “coughing,
wheezing and flare-ups.”
“The same body of evidence also suggests long term
complications including lung disease,” he said, noting “some e-cigarettes and
vapes may contain higher nicotine quantities than a regular cigarette.
Therefore, at times it is like smoking an entire pack of cigarettes in terms of
nicotine consumption.
The quantity of nicotine per vape cartridge is
irrelevant to this discussion. It is, of
course, greater than that in a cigarette, or even a pack of cigarettes, because
vape products deliver doses of nicotine over periods longer than the typical
cigarette’s 10 puffs. Vape cartridges are
designed to be used over the course of hours or days.
Your lungs are at
risk
Vaping still puts your lung health at risk, said Dr.
Bangash, noting “there’s evolving evidence of the impact of e-cigarettes on the
lungs and the health risks associated with it.”
Earlier, the author asserted that the lung health risk
was “proven evidence”; now it’s “evolving”.
This dithering underscores the gross inaccuracy of Dr. Bangash’s
argument.
Brain development is
affected
“Unfortunately, e-cigarettes and vapes are predominantly seen within the youth,” said Dr.
Bangash, noting “the brain is still developing until your early- to mid-20s.
“When nicotine is consumed during the period of brain
development, it can lead to long-lasting effects because it dysregulates some
of the neuronal circuits in the brain that affect control, attention, impulse
and mood,” he added.
There is no scientific evidence to support the claim
that nicotine causes harm to human brain development (discussed here). In fact, the 30 million adult current smokers
and 56 million former smokers in the U.S., virtually all of whom started
smoking when they were teenagers, show no brain “neuronal” dysfunction and there
is no evidence that their brain development was harmed.
Vaping can be
addictive
E-cigarettes and vapes “all stem from nicotine, which is a
highly addictive substance. When you vape nicotine, it does the same—it
dysregulates activity in several parts of the brain,” Dr. Bangash said, noting
“it can affect neuronal pathways.”
Nicotine is addictive; so is caffeine.
“The end result is, all of those changes in the brain make
nicotine more desirable,” he added. “So, vaping can cause a similar pattern of
addiction or sometimes even worse as compared to cigarettes.”
The scientific literature tells us that vaping is far
safer than smoking, full stop.
Vaping not shown to
help you quit
“No e-cigarettes or vapes have been found to be safe and
effective by the” Food and Drug Administration (FDA) in helping smokers quit”,
he emphasized.
Dr. Bangash should know that “safe and effective” are
standards applied to medical interventions by the FDA.
"Another major misconception is that switching to
e-cigarettes or vaping is a way to quit smoking traditional cigarettes,” said
Dr. Bangash. “Using any other tobacco product or any other product that
contains nicotine is not actually quitting.”
This is not a misconception. Population evidence that smokers are
switching was published years ago (here and here).
Two smoking cessation trials, published in the New England Journal of Medicine
in 2019 and 2024 clearly
demonstrate that vapor products help smokers quit.
Arguing that vaping is not “actually quitting” demonstrates
Dr. Bangash’s real goal of nicotine abstinence.
Vape marketing
confuses people
“A lot of vape companies want consumers to believe
switching to other tobacco products, including vapes or e-cigarettes is a way
to quit,” said Dr. Bangash. “However, it is not, and there are a lot of
unproven health claims made by the e-cigarette or vape industry that is
confusing people who actually want to quit smoking.
“This creates a lot of confusion for people who really want
to quit typical cigarettes and they feel that going to e-cigarette will be a
way to help, but that’s not exactly true,” he added.
My previous comment demonstrates that the utility of
vaping as a stop-smoking mechanism has been proven.
Secondhand vape
smoke not understood
Many people have questions about the effects of secondhand
smoke from e-cigarettes and vape pens, which is “a good question” to ask, said
Dr. Bangash. Unfortunately, “the long-term harm from secondhand vape smoke is
not well understood.”
Vape smoke is not a thing. Dr. Bangash and the AMA
should know better.
“However, the aerosol from vape smoke does contain
nicotine, heavy metals and formaldehyde, which in the short term can cause
bronchitis, asthma flares and worsening breathing over time,” he said.
These claims are baseless. Facts are available on heavy
metals (here),
formaldehyde (here, here and here) and
false respiratory claims (here).
Parents: Set an
example
“Parents are very powerful influences on their children and
it is important to maintain an open dialogue early on and express to children
that smokeless tobacco, e-cigarettes, vapes, all have dangers including
nicotine and nicotine addiction,” said Dr. Bangash. “One of the common things
kids will face is peer pressure, so as a parent, it’s important to prepare kids
for situations in which they may face pressure from their peers to use a vaping
device.”
“At the same time, the things we can do as
parents is to set a good example, never smoke
around kids and establish a smoke-free home,” he added. “So, whether it’s
yourself, your friends, your relatives, whoever, if you do not smoke it sets a
very positive example for kids.”
While parents should know about their children’s
potentially dangerous activities, vaping should be prioritized relative to
other prevalent risky teen behaviors, such as:
Do not
always wear seat belt 40%
Current
text/email while driving 36%
Current
drink alcohol 23%
Seriously
considered suicide past year 22%
Sexual
intercourse past 3 months 21%
Didn’t
wear condom 48%
Current
marijuana use 16%
Bullied on
school property past year 15%
Current
ride with driver had been drinking 14%
Current
binge drink 11%
Centers for Disease Control and Prevention. High School
YRBS Online. https://nccd.cdc.gov/youthonline/App/Default.
Educational
campaigns discourage vaping
“The FDA started a campaign called ‘The Real Cost,’” said
Dr Bangash, “and the Truth Initiative started a campaign called ‘It’s Messing
With Our Heads.’”
“These are educational campaigns that primarily target the
youth and aims to prevent the youth from using vapes and preventing nicotine consumption in addition to other
objectives as well,” he said.
While the FDA claims it’s PR campaign prevents youth
e-cigarette initiation, it clearly dissuades adult smokers from using
e-cigarettes to quit (here).
Have a quit plan
“The most important thing when planning to quit vaping or
smoking cigarettes, is to have a quit plan,” Dr. Bangash said. “In order to
help with the quit plan, talk to your doctor who can help develop a quit plan
which can include medication and counseling.
“Together, the combination of medication and counseling has
resulted in very high success rates of quitting for good,” he added. “There are
also Quit Lines where patients can talk to trained “quit” coaches to help
assist in this process and motivate patients to continue with their quit
plan.”
Population estimates of quitting with FDA-approved
methods are abysmal, and 480,000 American smokers don’t quit in time to avoid
untimely death.
It is also important “to understand with vaping, just don’t
switch. Quit tobacco for good,” Dr. Bangash said. “We know from all the
evidence and data around cigarette smoking is that quitting smoking is the
single best thing to improve overall health.”
“It’s important to not get confused by unproven claims made
by tobacco and e-cigarette companies. Just quit smoking for good and if you
need assistance or help, please talk to your doctor,” he added. “And as a
parent, please take it upon yourselves to educate your children about the
hazards of smoking and be a positive influence for your kids and establish a
smoke-free home.”
The final word, paraphrasing Dr. Bangash: “It’s
important to not get confused by unproven claims from medical professionals and
organizations. Just quit smoking for good, which you can accomplish with or
without nicotine abstinence. Educate
your children about the hazards of smoking and be a positive influence for your
kids and establish a smoke-free home.”Top of Form
