Nature Nurtures Nicotine Nonsense

 

The prestigious scientific journal Nature draws considerable attention to its articles from scientists and others worldwide.  That makes it imperative that we point out the many serious flaws in a recent article, misleadingly titled, “Is nicotine bad for long-term health? Scientists aren’t sure yet.”

At this writing, MEDLINE, “the world's leading bibliographic source for biomedical scholarly literature and research,” offers citations to 28,241 articles with the keyword “nicotine”.  While it is true that science always demands additional research, one can reasonably assume that there is sufficient data on nicotine effects to draw meaningful conclusions about its safety.

Apparently, the authors of the Nature article went to great lengths to secure comments from what is surely a minuscule community of “unsure” scientists and from entrenched opponents of recreational nicotine consumption and tobacco harm reduction. 

Aruni Bhatnagar, who runs a tobacco regulation and addiction center sponsored by the American Heart Association, is quoted saying, “We believe that much of the cardiovascular effects of smoking are because of nicotine,” and he postulates that the drug can change the timing of electrical signals in the heart.  This sounds ominous, but the article includes a refutation of these comments by Neal Benowitz, a recognized nicotine authority: “Nicotine is a minor player with respect to smoking-induced cardiovascular disease.”  Benowitz points to “studies of snus – a chewable tobacco product that is popular mainly among men in Sweden and is gaining traction elsewhere – which do not generally show a detectable rise in heart problems among people who use it.”

Maciej Goniewicz of the Roswell Park Cancer Center in Buffalo offers insignificant insights, such as, “[Nicotine] changes lots of functions in our bodies, it’s not a harmless compound.”  That can be said of everything humans consume.  Goniewicz also muses, “Someone chronically exposed to nicotine might have chronic inflammation. There is speculation that it might contribute to increased risk of cancer. [Emphasis added] From animal and cell studies, yes, nicotine is doing something. How this translates into a risk for the [human] user, we don’t know.”  Benowitz counters: “the evidence, for me, is not convincing in tying [nicotine] to cancer in humans.”  The evidence for a nicotine-cancer link is next to nil.

Frequent nicotine critic Laura Crotty-Alexander of the University of California San Diego notes, “We’ve underplayed the role that nicotine has in the health effects of tobacco products.”  Basing her opinion on her own research, in which cells and animals are tortured with nicotine (more info here and here), she offers a weak indictment of the drug, saying, “I’ve been more and more surprised at the changes I’m seeing when I expose cells to nicotine.”

One of the most extreme views in the Nature article comes from Kjersti Aagaard, a maternal-fetal doctor at Houston’s Baylor College of Medicine: “No amount of nicotine is known to be safe in pregnancy. None. If you are exposed to nicotine in the womb, there could be lifelong consequences.”  Aargaard implies that failure to meet that standard could have criminal consequences for the pregnant woman, but the journal contrasts those remarks with the position of the UK National Health Service, which “describes e-cigarettes as safer than smoking for pregnant women, but it notes that there is little research to support the safety of e-cigarettes beyond that. It recommends pregnant women use nicotine patches and gums to stop smoking.”  This is but one example of the startling differences between prohibitionist American and science-based British positions on vaping.

Despite the Nature article’s complaint that “the lack of knowledge about whether nicotine contributes to the damaging health effects of smoking is becoming more worrying,” there is a wealth of knowledge supporting the finding that the effects of nicotine on health are minimal to nonexistent. 

 

   

The New York Times Plays Patsy for Anti-Tobacco Voices

In the tabloid tradition of “If it bleeds, it leads,” The New York Times ignored the lack of peer review and wasted no space on critical analysis when it ran a May 3 article by Matt Richtel titled “Some E-Cigarettes Deliver a Puff of Carcinogens.” (here). 

Based on two unpublished studies, the Times reported that “the high-power e-cigarettes known as tank systems produce formaldehyde, a known carcinogen, along with the nicotine-laced vapor that their users inhale.  The toxin is formed when liquid nicotine and other e-cigarette ingredients are subjected to high temperatures... This finding suggests that in certain conditions, [e-cigarettes] might expose their users to the same or even higher levels of carcinogenic formaldehyde as tobacco smoke.” 

The Times also said the new research shows that when users are “dripping” – placing drops of e-liquid directly onto an e-cig’s heating element – “formaldehyde and related toxins ‘approach the concentration in cigarettes.’”

The studies are the work of Roswell Park Cancer Institute assistant professor Maciej L. Goniewicz, and Alan Shihadeh at Virginia Commonwealth University and the American University in Beirut, respectively.  Goniewicz’s article will reportedly appear in the May 15 edition of Nicotine & Tobacco Research, while Shihadeh’s has not been accepted or peer-reviewed anywhere (the Times says it “is being prepared for submission to the same journal”). 

The Times story represents a deeply troubling development: the global publicizing of research before publication or even submission to a medical journal.

This high-profile pre-release tactic has become commonplace for anti-tobacco pronouncements from the CDC and other federal agencies.  Media outlets give these biased stories wide distribution free of critical analysis or balance.    

Historically, release of findings prior to a journal’s publication date was grounds for cancelling an article.  In a recent post I suggested that peer review of tobacco research is nearly nonexistent at some journals (here).  It is further disappointing that journals are active partners in the selective release of research findings to the public.