British Medical Association Misleads On E-Cigarettes

Dr. George Rae, chairman of British Medical Association Northeast, made reckless comments about e-cigarettes in a March 31 BBC radio interview, available here.  I highlight Rae’s most egregious claims in the transcript provided by Clive Bates.

Interviewer: “Give us the science bit: How dangerous could they be?”

Rae: “[...] You've got to realise that there are chemicals within e-cigarettes, particularly a group of chemicals called nitrosamines, and nitrosamines can cause cancer, and they [e-cigarettes] can be even more cancer forming than what you're getting within cigarettes themselves.”

Rae: “Obviously as a doctor that is causing me concern because there is the perception by obviously many people that, ‘well I'm not smoking cigarettes which have got tar and have got nicotine and therefore that this is a safe substitute.’  Well what I think what has got to be coming across loud and clear, and I've been on the airwaves in the previous months and other doctors [are] saying ‘look hang on, this isn't the case, there are chemicals within those e-cigarettes and these are serious chemicals’ and I've given you one example, the nitrosamines.”

Rae: “So there are lots and lots of concerns about e-cigarettes.  I don't think you'll get many, if indeed any, doctors coming on the radio and saying ‘look it's okay they’re an acceptable substitute and let's just go with it.’  I think nothing could be further from the truth.”

Interviewer: We often hear about tar, you know in the advertisements from years ago, it’s all about the tar causing the problems.  But with e-cigarettes, if there’s different types of chemicals, by the sounds of it they can cause the same types of problems.”

Rae: “Absolutely!  No, there's absolutely no doubt about that at all. That is the whole point, they are being marketed as something which is safe and a safe substitute.  And that's not the reality.  I don't think there have been any clinical trials done on e-cigarettes and anyway doctors wouldn't get involved in anything which wasn't regulated.” [BR note: The BMA spokesman ought to be aware of the growing body of scientific evidence here].

Interviewer: But surely it's better than the alternative [smoking]?

Rae: No, it's not better.  Because what I'm actually trying to get across and I'll say it again, there are potentially more cancer forming chemicals within e-cigarettes than you've actually got in cigarettes per se themselves. Now nobody's going to go on the air and say, you know, that is better for you - it's not!  It's actually a bit of a time bomb that people are actually unaware of.  I think you are not going to find the medical profession relenting on the message we are trying to get across on e-cigarettes.

The British Medical Association ought to assure that its spokespeople are properly educated and stick to the facts on such an important public health matter.

BBC Drops the Ball on Baseball & Smokeless Tobacco

It’s almost baseball season, which means it’s time for anti-tobacco extremists to start grabbing easy headlines.  One especially zealous state lawmaker wants to ban smokeless tobacco by players and fans in all California ballparks (here).  It’s all based on smoke and mirrors, as illustrated in a woefully inaccurate recent BBC story on smokeless tobacco and baseball.

The report includes an erroneous claim that baseball stars Tony Gwynn, Curt Schilling and Babe Ruth died from cancers caused by smokeless tobacco. 

Neither Gwynn’s nor Schilling’s cancer was related to smokeless products, as I have detailed before (here and here).   Reporter Nada Tawfik concedes that “doctors say a link between [Gwynn’s salivary] cancer and chewing tobacco cannot be proven.”  I have previously noted the absence of a scientific link between smokeless tobacco and this cancer type (here).  As for Schilling, he never said he had mouth cancer and not one of his doctors has supported his statement that smokeless tobacco caused his illness.

The BBC repeated the decades-old myth that Babe Ruth suffered from smokeless tobacco-induced mouth cancer.  In truth, Ruth had nasopharyngeal carcinoma, a rare disease caused by the Epstein-Barr virus.  Ruth was a prodigious consumer of cigars and alcohol, but neither are strongly associated with nasopharyngeal carcinoma (discussed here).  He also used smokeless tobacco, which has no link to this cancer type.

Included in the BBC story was a remarkable quote attributed to Dr. Jatin Shah, who runs the Head and Neck Service at New York’s Memorial Sloan Kettering Cancer Center.  Chewing tobacco, he is reported to have said, is “probably more harmful than smoking.”  I emailed Dr. Shah to ask if he had been misquoted.  He responded with a comment on South Asian products, but the BBC’s vast audience has been left with the grossly erroneous impression that American smokeless tobacco is more dangerous than cigarettes.

Thus are myths perpetuated and the public health undermined.