Yesterday, the journal Thorax published a new study that analyzed 145 different e-cigarette products and reported the levels of the chemical benzaldehyde found in the products. As expected, the research team, led by Dr. Maciej Goniewicz of the Roswell Park Cancer Institute (RPCI), found that benzaldehyde (an organic compound found in many flavorings) was present in most of the products studied. The authors found that the levels of benzaldehyde were significantly higher in cherry flavored products.
As is always the case with studies on chemicals, the principle tenet of toxicology for hundreds of years must be kept in mind — the dose makes the poison. The presence of a scary-sounding chemical does not mean that the chemical presents any harm. It is the levels present that determine whether there is potential harm.
To the credit of Dr. Goniewicz and the RPCI, they went to significant efforts to see that their study was not misreported. In both the abstract and the body of the study they note:
Levels in cherry-flavoured products were >1000 times lower than doses inhaled in the workplace.
The estimated median daily inhaled dose of benzaldehyde from cherry-flavoured e-cigarettes was 70.3 μg, which would be >1000 times lower than the [permissible exposure limit] dose for benzaldehyde concentrations in the workplace.
Commenting to HealthDay, our friends at the the Smoke-Free Alternatives Trade Association point out that it would take three years of vaping to reach the maximum levels of benzaldehyde that a worker is allowed to be exposed to during an eight-hour shift.
Once again to his credit, Dr. Goniewicz went even further than required in trying to stop the media from inaccurately reporting his study. He stated the following in a press release:
If [e-cigarette users] notice irritation, maybe a cough or sore throat, when they use e-cigarettes, they might want to consider switching to a different flavoring. And it’s also important to keep these findings in perspective. The potential harm, if any, from inhaling flavored e-cigarettes would probably not even approach the dangerous, deadly effects of tobacco. It will be important to follow this work up with studies that assess the long-term effects and chronic toxicity of e-cigarette flavorings in humans.”
So let’s be clear here — the levels of benzaldehyde that a daily vaper is exposed to are over 1,000 times less than what a worker is allowed to be exposed to. Additionally, even the lead author of the study disputes that these findings support a belief that vaping could be as hazardous as smoking.
So how did the health reporters react?
At Newsweek (archived version), Jessica Firger irresponsibly declared that whether vaping is less hazardous than smoking “may depend on which flavor you choose.”
At the Daily Mail (archived version), it somehow took two reporters — Lisa Ryan and Anna Hodgekiss — to get the story completely wrong. “Cherry flavoured e-cigarettes may be more harmful to health than other types – or even regular cigarettes, new research suggests,” they write.
Others, like Salynn Boyls of Medpage Today, didn’t actively mislead, but instead declined to report on either the extremely low levels found or Dr. Goniewicz’s statement about relative risk.
As Iowa Attorney General Tom Miller pointed out in November, there is a serious public health problem emerging in the United States with regard to knowledge of the relative risk of different nicotine products. With each passing year, more and more smokers are inaccurately believing that vaping is just as hazardous as smoking.
In 2016, even the most ardent of e-cigarette opponents will generally concede — sometimes after some prodding — that there is virtually no doubt that vaping is far less hazardous than smoking. The debate in the public health community isn’t whether vaping is less hazardous than smoking; it’s how much less hazardous.
So why are health reporters continuing to push this junk? It’s one thing to be lazy when you’re handed an irresponsible press release — it’s an entirely different matter when, as is the case here, you ignore the press release and just make up your own facts for the sake of creating a salacious story.
~ Gregory Conley, President, American Vaping Association