Public Health England’s claim that e-cigarettes are 95 per cent safer than tobacco is outdated and misleading, according to scientists.
The government body stands by the claim – but Virginia Commonwealth University researchers said it’s based on old evidence and is no longer relevant.
E-cigarettes have changed ‘significantly’ since the studies on which the 95 per cent line is based, they said in an opinion piece.
But the team did not offer its own estimate on how much safer they are. Experts maintain, however, that vaping is ‘considerably’ better for your health.
They also said making vaping seem totally safe attracts people who never smoked in the first place, potentially leaving them hooked on nicotine.
The editorial, written by six experts based at the US university, comes as increasing numbers of health dangers are being reported by doctors.
The US is in the middle of a vaping illness crisis, with e-cigarettes thought to have struck down more than 2,500 people and killed 55.
Regulations in the US and UK are different, with American products allowed to contain more nicotine and be more aggressively advertised.
‘It doesn’t make any sense for us to claim that we know that it’s 95 per cent safer than combustible cigarettes,’ said Dr Thomas Eissenberg, one of the authors.
‘We’ve been studying cigarettes for the last 60 to 70 years and so we have a huge database with which we can look at how many people die from that behavior.
‘We don’t have anything near that kind of history with electronic cigarettes.
‘What we do know is that they are delivering toxicants to the human lung and that over repeated use, in some cases, we see health effects from those toxicants that e-cigarette users are inhaling.
‘People are using the claim as a reason to either keep using e-cigarettes if they started some time ago, or if they’ve never used nicotine before, they hear 95 per cent safer than combustible cigarettes and they say, “Well, that’s safe enough for me” and so then they start using.’
Dr Eissenberg is a director of Virginia Commonwealth University’s Center for the Study of Tobacco Products, and published the piece alongside five colleagues.
They said the safety claim, first made by independent scientists, had been ‘widely publicized, notably by Public Health England and the Royal College of Physicians’.
They did not do a scientific study of the dangers of e-cigarettes but looked at the evidence on which the 95 per cent claim was first made in 2014.
And since then, they said, the technology of the devices and the ingredients of the liquids have both changed, and more evidence has come to light of health dangers.
The e-cigarettes or inhaling devices themselves are now up to 20 times more powerful than they were in 2013, the researchers said, meaning they produce more chemicals in a puff.
There are thousands of flavouring liquids being sold around the world and they contain chemicals for which the effects of inhaling them aren’t known.
And liquids may now contain higher concentrations of nicotine, which has its own health risks and is highly addictive.
‘In addition to using different materials and more numerous heating coils, many e-cigarettes today can attain power output that exceeds that of most over-the-counter 2013 models by 10 to 20 times,’ the researchers wrote.
‘Greater power increases the potential harms of e-cigarette use because more aerosol is produced that exposes users to increased levels of nicotine and other toxicants.’
Health dangers scientists have associated with e-cigarettes include those posed by nicotine and chemicals called aerosols.
Nicotine is known to be able to damage brain development, and aerosols, when inhaled, can cause physical damage to the lungs because of heavy metals like lead, volatile organic compounds, and cancer-causing agents.
Vaping has also been linked to damage to blood vessels and an increased risk of stroke or heart attack.
Public Health England repeated the 95 per cent safer claim as recently as October 2019 in a graphic posted on its Public Health Matters blog.
It has used the tagline since 2015 when it published an expert review of evidence and launched a campaign to encourage smokers to switch to e-cigarettes.
In a press release after a later review, in 2018, Professor John Newton, director for health improvement at PHE said: ‘Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95 per cent less harmful, and of negligible risk to bystanders.’
The Royal College of Physicians, a UK-based organisation which represents 37,000 doctors around the world, also stands by the claim.
In a statement to MailOnline today it said: ‘The Royal College of Physicians has previously stated that while vaping may not be completely “safe”, the hazard to health arising from long-term use of e-cigarettes available today in the UK is unlikely to exceed 5 per cent of the harm from smoking tobacco.’
Jasmine Khouja, a PhD student in the University of Bristol’s Tobacco and Alcohol Research Group, told MailOnline: ‘With the availability of many new products since the “95% safer” estimate was made, it is likely that this specific estimate is outdated.
‘Much of the evidence cited in the [current] study does not directly compare using e-cigarettes to smoking, making it difficult to assess whether using e-cigarette is safer than smoking when looking at these findings.
‘Additionally, studies which have shown the health benefits of switching from smoking to e-cigarette use have been omitted.
‘Although e-cigarettes are not risk-free, the evidence still seems to suggest that using e-cigarettes is considerably less harmful than smoking.’
The dangers of e-cigarettes are now being seen in real-life patients, particularly in the US.
Last year a total of 2,561 people needed hospital treatment because of a newly-identified condition called vaping-associated pulmonary illness (VAPI).
People suffered breathlessness, fever, cough, vomiting, headaches, dizziness and chest pain because of their e-cigarettes and 55 people in 27 states died.
Officials say a chemical called vitamin E acetate, which is mainly used in cannabis vaping products, was to blame for most of the cases.
And a study published earlier this week showed that e-cigarette users have been reporting health problems caused by their habit online for at least 12 years.
Until now, the issues – which included asthma, sore throats and coughs and colds – may not have been blamed on vaping, a relatively new phenomenon.
Dr Eissenberg and his team’s editorial was published in the American Journal of Public Health.
Professor John Newton, director of health improvement at Public Health England, said: ‘This research tells us nothing new.
‘Medical bodies across the world agree that e-cigarettes are not without risk but are far less harmful than smoking which kills 220 people every day in England.
‘The 95 per cent estimate was developed by independent academics that we agreed was a reasonable estimate at the time and a helpful way of communicating the different scale of risk between smoking and vaping, that people can easily understand.
‘PHE is constantly reviewing the evidence around e-cigarettes and we shall publish our next review in the next couple of months.’
