The World Health Organization (WHO) published an astonishingly bad Q&A on electronic cigarettes on January 20, full of lies of omission, outright falsehoods and hyperbole.

While the WHO has plenty of past form on this issue, it remains shocking that a prestigious organization employing some of the world’s foremost experts on health whose work has improved or saved the lives of billions of people, have jumped on the regressive anti-tobacco harm reduction bandwagon.

Here’s one deceptive whopper in the new release: “There is no doubt that they [e-cigarettes] are harmful to health and are not safe, but it is too early to provide a clear answer on the long-term impact of using them or being exposed to them.”

And here’s the WHO on teen brains: “Nicotine is highly addictive and young people’s brains develop up to their mid-twenties. Exposure to nicotine can have long-lasting, damaging effects.” The WHO offers no scientific evidence to back up this claim.

One can only ask what forces have “hijacked the brains” of scientists and doctors at the WHO. Over a decade of research shows that vaping is vastly safer than smoking cigarettes, and that e-cigarettes are more effective for smoking cessation than nicotine-replacement therapy. The WHO’s release entirely omits the critical matter of the relative risk of vaping compared to the cigarettes that kill millions every year.

The stain of the WHO putting out anti-vaping propaganda will not soon fade. And many smokers around the world who will thereby be denied access to vaping products or persuaded away from them will pay the ultimate price.

In an effort to redress the massive imbalance of information, Filter asked several international experts in vaping and tobacco harm reduction for their reactions to the WHO Q&A.

Louise Ross, former manager of the Stop Smoking Service, Leicester, England:

“I’m already getting calls from healthcare professionals who now think that vaping is more dangerous than smoking, because of the WHO report that misleads and confuses. I’m so angry that this will increase the numbers of people who continue to smoke or go back to smoking because they have been misinformed by an organisation that claims to care about health.”

Chelsea Boyd, MS, research associate for harm reduction policy, R Street Institute;* and Filter contributor:

“It will be years or decades before population-level data that can accurately assess the long-term safety of e-cigarettes without bias from past smoking behavior is available to researchers. However, we already know that combustible tobacco products are unsafe and cause more death and disease than any other consumer product. We also know that after more than 10 years on the market, evidence of harm from the use of legally obtained e-cigarettes is limited, while anecdotal and empirical evidence of their benefit to smokers is widespread.”

“The WHO needs to weigh the relative risk of e-cigarettes, compared to combustible tobacco products, rather than focusing exclusively on the absolute risk. Although public health should not forget the ‘tobacco wars,’ health organizations also must not perpetuate those wrongs by shunning innovative products that have the potential to decrease the extensive and known harm caused by combustible tobacco products.”

Amelia Howard, PhD candidate in Sociology, Department of Sociology and Legal Studies, University of Waterloo, Ontario, Canada:

“The WHO has a long history of politically biased risk communications when it comes to e-cigarettes, but their most recent ‘fact sheet’ is shockingly bad. The document is recklessly dishonest, dangerously misleading to the public, and difficult to see as anything other than prohibitionist propaganda. In my opinion, it represents a new low for the organization on this issue.”

“The WHO’s e-cigarette ‘facts’ are not simply misleading, most of them are demonstrably false. Such reckless disregard for the truth not only undermines the credibility of the WHO, but fuels public distrust of science and expertise. The entire fact sheet warrants an immediate retraction.”

“Some of the more glaring falsehoods that caught my eye:

WHO: Do e-cigarettes, electronic nicotine delivery systems(ENDS) cause lung injuries? There is growing evidence to show that ENDS use could cause lung damage. On 17 September 2019, the United States Centers for Disease Control and Prevention activated an emergency investigation into links between ENDS use and lung injuries and deaths. By 10 December 2019, the USA reported more than 2409 hospitalized cases and 52 confirmed deaths.”

Amelia Howard (AH): This would be laughable if the consequences weren’t so dire. For some time now there has been ample evidence pointing to Vitamin e acetate (an additive in illicit market THC cartridges that is not used in ‘ENDS’) as the culprit in the lung injury outbreak and it’s simply unacceptable that the WHO ignores this here. Moreover, three days prior to the publication of the WHO fact sheet, the CDC specifically and publicly backtracked on their inappropriate blanket warning against all vaping, and narrowed their recommendations to products containing THC.

WHO: The liquid in e-cigarettes can burn skin and rapidly cause nicotine poisoning if swallowed or absorbed through the skin. There is a risk of the devices leaking, or of children swallowing the liquid. The liquid is also highly flammable.

AH: I do not know the origin of the claim that e-liquid is flammable, or the claim that it can burn someone’s skin, but there is no truth to either statement. The nicotine in e-cigs is not magically different from the nicotine used in widely available, non-prescription NRTs [nicotine replacement therapies]. It’s notable that these products are on the WHO’s list of essential medicines. In many cases, nicotine concentrations in NRTs are higher than eliquid, but I’ve never heard of a Nicorette patch burning a hole in someone’s arm.

WHO: Are secondhand e-cigarettes emissions dangerous? Yes. The aerosols in e-cigarettes typically contain toxic substances, including glycol which is used to make antifreeze.

AH: Glycols are a class of organic compounds, some of which are toxic to humans, some of which are safe, and the WHO’s failure to differentiate between non-toxic propylene glycol used in e-cigarettes (as well as pharmaceutical products, foods, cosmetics and fog machines) and the toxic ethylene glycol in anti-freeze is incredibly deceptive. When propylene glycol is added to anti-freeze it is to reduce toxicity to humans and animals. More generally, the current evidence does not support claims that so-called “second-hand” vapor poses a meaningful risk to bystanders. While exhaled vapor does contain homeopathic levels of nicotine, these levels are so low that there is no plausible mechanism by which they could cause any harm to bystanders (I’m paraphrasing the 2016 RCP report here).”

Samrat Chowdhery, director, Association of Vapers India; vice president, International Network of Nicotine Consumer Organisations (INNCO); and Filter contributor:

“WHO’s transition from caution to spreading misinformation on e-cigarettes will have severe impact on low-middle income countries (LMICs) which depend heavily on its directions to frame policy. Given that 80 percent of the world’s current smokers live in LMICs with inadequate access to public healthcare, this scaremongering will deny them effective, low-cost preventive measures, which is inimical to WHO’s goals of preventing tobacco-related mortality and morbidity.”

David Sweanor, adjunct professor of Law, University of Ottawa, Canada:

“To say that e-cigarettes are not safe is as accurate as saying the same about seatbelts, condoms, sterile syringes, sanitary food and clean drinking water. Nothing is absolutely safe. But for the WHO to use such sophistry to mislead the public on relative risks compared to the likely alternative is negligent and deadly.”

Marewa Glover, Centre of Research Excellence-Indigenous Sovereignty & Smoking, based in New Zealand; and Filter contributor:

“Millions of people around the world have stopped smoking thanks to the mass exodus from combustible cigarettes to vaping, snus and tobacco heating devices. They, and the many thousands of health professionals and family members who are observing and supporting this lifesaving transition know how very wrong the WHO are in their anti-tobacco harm reduction stance. So many of us have lost faith in the World Health Organization—they cannot be trusted to follow the science, or to do what is right. This makes the threat of the coronavirus—a real threat—even more frightening.”

*The R Street Institute previously provided a restricted grant to The Influence Foundation, which operates Filter, to support production of two reports on harm reduction topics.

Photo by United States Mission Geneva via Flickr: World Health Organization Headquarters and Flag/ Creative Commons 2.0.