A recent statement by Australia's Chief Medical Officer and State and Territory Chief Health Officers, ‘E-cigarettes linked to severe lung illness’ is alarmist, potentially misleading and does not accurately reflect the current scientific evidence on vaping, a group of 31 leading health professionals has announced today.

The announcement led by the Australian Tobacco Harm Reduction Association (ATHRA) said that the statement implies ‘vaping for smoking cessation’ has contributed to the outbreak of severe respiratory illness in the US. (full critique available here)

Foundation Chairman of ATHRA Conjoint Professor Colin Mendelsohn said

"the outbreak is almost exclusively caused by illicit, street purchased THC (cannabis) oils contaminated with vitamin E acetate"

“There has not been a single case linked to 'vaping for smoking cessation' and it is important to differentiate that from the use of illicit drugs and their harmful effects,” Professor Mendelsohn said.

“This outbreak has only occurred in parts of the US, mainly in young men which is the typical pattern of an outbreak of bad batch of illicit drugs. Yet 40-50 million people of all ages in dozens of countries have been vaping nicotine for at least 10 years without any similar cases occurring. These observations alone suggest that vaping nicotine is most unlikely to be the cause of this outbreak. “

Emeritus Consultant at St Vincents’ Hospital Alcohol and Drug Service, Darlinghurst Sydney, Dr Alex Wodak AM said the statement by the Chief Medical and Health Officers raises concerns about other potential risks from vaping. However, risks need to be quantified or compared to a benchmark to be meaningful.

“Low doses of toxic chemicals are only a risk to human health if the dose is sufficient to cause harm. The risk from vaping is only a tiny fraction of the risk of continuing to smoke"

"Up to two out of every three smokers die from a smoking related condition,” Dr Wodak said.

“The warning focuses only on the potential risks of vaping and fails to consider the huge potential public health benefits. Modelling studies have shown that the net impact of vaping is to save many lives, even after potential risks have been taken into account. Vaping is the most popular and, according to some studies, the most effective way of quitting smoking. It has already begun to disrupt the tobacco industry like nothing else has before.”

The statement does not recognise the role of vaping for Tobacco Harm Reduction (THR). THR aims to reduce (not eliminate) harm for smokers who cannot quit by substituting a lower-risk product for combustible tobacco. The only alternative to vaping for many addicted smokers is just to continue smoking. There are 19,000 deaths from smoking-related illness in Australia each year. There has not been one death from vaping nicotine liquid.

“By misleading the public about vaping, this guidance will cost Australian lives. Misinformed and frightened vapers may return to deadly smoking and other smokers may not make the switch to the safer product,” Professor Mendelsohn said.

“Australia’s smoking rates have stagnated since 2013. Australians need new and effective strategies to help smokers quit. Australia remains the only western democracy to ban the sale and use of nicotine for vaping.”

Australian smokers can get much more helpful and evidence-based advice about vaping from the New Zealand Ministry of Health vapingfacts.health.nz and from Public Health England here.

Instead of a blanket warning to avoid vaping, a more nuanced, evidence-based approach would be more helpful to Australians, such as:

The healthiest option is not to smoke or vape

Don’t start vaping if you don’t already smoke

Adult smokers who are unable to quit smoking with conventional treatments can consider vaping nicotine as a short-term quitting aid or as a long-term safer substitute for smoking

If you vape, it is important to quit smoking completely

Street drugs should be avoided at all costs. Illicit products are often contaminated, have unknown ingredients and no quality control

Documents

E-cigarettes linked to severe lung illness. Statement from the Chief Medical Officer and State and Territory Chief Health Officers about e-cigarettes and an emerging link between their use and lung disease. 13 September 2019

A critique of ‘E-cigarettes linked to severe lung illness’ by 31 leading health professionals. 18 September 2019