5 Vaping “Facts” You Don’t Want to Know

 

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.

Bloomberg Tobacco Article Misleads on Nicotine Effects

In an article published on March 4, Bloomberg reporter Tiffany Kary quotes from a February 25 letter sent to the FDA from Paige Magness, tobacco manufacturer Altria’s senior vice president for regulatory affairs. 

Per the article, “Altria asked the FDA to tackle misperceptions about nicotine as part of a proposed $100 million advertising campaign to reduce the harm caused by tobacco…three-fourths of U.S. adults incorrectly believe[e] nicotine causes cancer, Altria said in the communication, citing government research.”

While National Cancer Institute survey data show that only 25% of Americans correctly believe that nicotine does not cause cancer, Bloomberg erroneously asserts “it’s been known for years that nicotine isn’t the direct cause of many of smoking’s ills.”

The article continues, “The drug has even been touted as a way to ease tension and sharpen the mind,” before noting that it is “the ingredient that addicts people to tobacco products, and it has risks, including possibly making people more susceptible to abusing opioids.”

“Tout” is a derogatory term meaning to describe or advertise boastfully.  Given that nicotine conveys many proven benefits (here, here), touting is not required.  Still, Bloomberg irresponsibly and inaccurately paints it as a gateway to hard drugs.

Altria is not wrong to ask the FDA to combat misinformation about nicotine and tobacco, but the agency is unlikely to act on their request.  FDA officials have made their position clear, saying, in essence, “We will continue to tell Americans that all nicotine/tobacco products are dangerous.  Any manufacturers’ claims to the contrary about their products must be approved by us first.”

Bloomberg says the agency “does have the budget and marketing chops to reach the masses through its public education campaigns. But the agency uses much of those resources on targeting the health risks of products made by the likes of Altria. Its recent ‘Real Cost’ ads say oral tobacco can cause mouth cancer [which is not true, according to government research here], tooth loss [totally bogus, here], brown teeth and jaw pain [also caused by coffee and chewing gum], while ‘most vapes contain seriously addictive levels of nicotine.’” 

In addition to filling smokers’ brains with misinformation, the FDA’s “Real Cost” campaign costs taxpayers real money.  In a commentary published last year in the American Journal of Public Health, I commented that “The [second] largest FDA Center for Tobacco Products budget item ($159.5 million, or 22%) supports public education campaigns and communications to ‘reduce tobacco use’ and tell ‘target audiences’ about the ‘harms of tobacco product use.’ (Original Reference 6)  In this category, ‘The Real Cost’ Youth E-Cigarette Prevention Campaign (http://bit.ly/2IWTSWj ) shows e-cigarettes invading adolescent bodies as worms and a magician converting e-cigarettes into combustible cigarettes. The FDA has acknowledged, apparently without concern, that the campaign convinces adult smokers that e-cigarettes are equally or more harmful than cigarettes, thus suppressing quitting. (Reference 7).”

Attempting to lend credence to the story, Bloomberg quotes Eric Lindblom, a lawyer who has worked for the FDA and for the prohibitionist Campaign for Tobacco-Free Kids.  Offering the pseudo-revelation that “Nicotine isn’t benign,” Lindblom opines that nicotine “can interfere with brain development [a documented fallacy] and birth outcomes” and closes with a non sequitur: “It’s an agricultural poison in large doses.”

What is the relevance of large-dose agricultural applications to smokers, dippers and vapers?  Absolutely zero, as with the value of the cited Bloomberg hit piece.