On the Safety of E-cigarettes: “I can Resist anything except Temptation”¹

Abstract

Strategic policy decisions are being made about e-cigarettes, based on the plausibility of their greater safety, rather than on essential scientific evidence which would permit a proper risk assessment. If e-cigarettes are really ‘safer’, then their use should be recommended, but only after an intelligent analysis of their risk to human health, based on integrated in silico, in vitro and clinical studies for both scientific and logistical reasons

The need to regulate electronic cigarettes amidst health concerns: Let’s follow the evidence

“…[25] The report by Public Health England (PHE), [26] on which the credibility of the claims about e-cigarettes has been hinged, is based on a study [27] reliant on the perceptions of 12 'experts': it did not consider evidence from research or clinical data; it did not conduct any form of risk assessment consistent with scientific methods; it relied on reports it commissioned that were not subject to peer review; some of the authors did not declare their conflicts of interest; and it was produced at a single consultative meeting partly sponsored by companies with links to the vaping industry. [24,28] Also, PHE is not a body responsible for directing public health globally.…”

Electronic Cigarettes: Can Dependable Public Health Policies be Developed and Applied without Relevant and Reliable Risk Assessments?

“…We further pointed out that such evidence could only be provided by integrated in silico, in vitro and clinical studies, for both scientific and logistical reasons. 5 Astonishingly, since it was published in 2015, our article has had more than 5,200 reads on ResearchGate, a professional network for scientists, with more than 15 million members from all over the world.…”

Do E-cigarettes Pose a Risk to Human Health?

“…Therefore an evidence-based assessment of the human health risk posed by e-cigarettes is needed. 1,3 But which data are most suitable for this purpose? Combes and Balls propose that an integrated scheme, which includes chemical analyses, physiologically-relevant organotypic human in vitro models, physiologically-based in vitro-in vivo exposure scaling, and human in vivo clinical investigations, should be used to quantify in vitro hazards posed by chemicals present in e-cigarettes and to assess their risk to humans.…”

“…In a Comment featured in this issue of ATLA, 1 Robert Combes and Michael Balls challenge the recent assertions by Public Health England that "…e-cigarette use is around 95% less harmful to health than smoking" and that "…e-cigarettes have the potential to help smokers quit smoking". 2 They point out that the position adopted by Public Health England on e-cigarette safety is not evidence based, mainly because it is not supported by a scientifically rigorous risk assessment.…”

“…This matters, because e-cigarette use is increasing rapidly in the UK and in many developed countries, whilst the smoking of tobacco has decreased. 1 The use of e-cigarettes will raise no concern if it is truly safe. However, were e-cigarette smoking to be unsafe, the adverse health consequences could prove to be substantial.…”