The latest e-cig love fest at the 2017 E-cig Summit in England has been bouncing around the internet, so I thought it would be worth summarizing some of the evidence debunking common e-cig myths. The list of citations is nowhere near exhaustive, but illustrates why these myths are myths.
https://tobacco.ucsf.edu/five-myths-about-e-cigs-and-some-evidence-they-are-well-myths
Myth 1: There is no gateway effect.
A recent meta-analysis shows 100% consistent evidence that never cigarette smoking youth who begin nicotine use with e-cigarettes are significantly more likely to progress to cigarette smoking than youth who do not use e-cigarettes. There have been several additional longitudinal studies published that have shown the same thing since this meta-analysis was published, including one from England.
There are also consistent data showing that e-cigarettes attract youth at low risk of beginning tobacco use with cigarettes and expanding the overall nicotine use market.
Myth 2: E-cigarettes increase smoking cessation.
A meta-analysis showed that, considering all available data at the time, e-cigarettes are associated with depressed cessation. While some of the studies published since then show increased smoking cessation among e-cigarette users, the overall pattern remains depressed cessation.
Myth 3: E-cigarettes are 95% safer than conventional cigarettes.
This assumption is based on the paper by Nutt et al that represented the opinions of a few ‘experts” without citing any specific supporting evidence. The process by which this paper was prepared has been criticized for conflicts of interest among some of the authors. More important, since then there has been a substantial literature published indicating important cardiovascular and pulmonary risks associated with e-cigarette use. Cardiovascular and pulmonary disease kill about 2/3 of smokers.
Myth 4: Even if smokers don’t quit when they use e-cigarettes they smoke fewer cigarettes and the health risks go down substantially in smokers that reduce consumption.
The claim that smokers who use e-cigarettes is also not consistently supported by the evidence. More important, even low levels of smoking convey substantial risks, especially for cardiovascular disease, where smoking even a few cigarettes is as dangerous as smoking 20 cigarettes a day.
Myth 5: Nicotine is addictive, but it doesn’t pose any other substantial risks.
Nicotine is a reproductive toxin. While not a carcinogen, nicotine plays an important role in promoting tumor progression by promoting cell proliferation and inhibiting normal cell death by activating nicotinic acetylcholine receptors and β adrenergic receptors. Nicotine also promotes the angiogenesis needed to supply blood to growing tumors. Nicotine’s effects on nicotinic acetylcholine receptors also accelerates atherosclerosis.It also aggravates lung disease and other diseases.