Thursday, May 13, 2010

Why is the American Lung Association Not Even Willing to Look at the Scientific Evidence?

There are at least 12 laboratory studies of the constituents of electronic cigarettes. These studies have characterized the chemical make-up of the liquid used in electronic cigarettes and therefore, provide an indication of the potential exposures of electronic cigarette users. The studies demonstrate, quite convincingly, that these products are far safer alternatives to cigarette smoking. No tobacco is present, there are only traces of tobacco-specific nitrosamines, the main non-nicotine ingredients - propylene glycol and glycerin - are generally recognized as safe, and the tests failed to reveal significant amounts of any chemical that is known to pose substantial health hazards.

However, as I revealed yesterday, the American Lung Association has apparently only considered the results of one of these studies. As I wrote yesterday: According to Connecticut's NBC affiliate, the American Lung Association is telling the public that there has been only one laboratory study conducted on electronic cigarettes: "We asked experts if e-cigs are safer than old-fashioned cigs. Michelle Marichal, of the American Lung Association, said the jury’s still out. 'We're reluctant because there have been no studies done except for one small one by the FDA... ."

Here are links to the additional studies that have characterized the chemical constituents of electronic cigarette cartridges or vapor:

Study 1

Study 2


Study 3

Study 4

Study 5

Study 6


Study 7


Study 8

Study 9

Study 10


Study 11

The Rest of the Story

The most disturbing aspect of the American Lung Association's dissemination of misinformation to the public about the relative safety of cigarettes compared to electronic cigarettes (they are equally safe, according to the ALA), is that the Lung Association's public statements are apparently the result of a very skimpy review of the scientific evidence. By its own admission, the ALA has only reviewed one report. Even that report has been misinterpreted, since it actually demonstrates that the levels of the identified tobacco-specific nitrosamines in electronic cigarettes are miniscule. They are comparable to levels found in nicotine replacement products.

I believe that if an organization is going to make public recommendations about an issue as important to people's health as whether or not they are better off using electronic cigarettes than smoking, it has an obligation to first review the available scientific evidence -- all of it, not just the study or studies it believes are favorable to its cause.

The Lung Association's failure to even consider the scientific evidence is particularly shameful because we are talking here about people's lives. If doctors made health recommendations to patients without bothering to review the evidence, it would be malpractice. Public health organizations, I believe, share the same obligation to make health recommendations that are based on the available evidence, rather than on pure speculation or ideology.

The ALA is certainly entitled to interpret the scientific studies differently than me, but to not even look at the studies before making its public recommendations is irresponsible and is a disservice to its constituents and the public.

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