An article published in The Lancet linking lung diseases to e-cigarettes has triggered reactions in the scientific community that supports tobacco harm reduction policies.

Riccardo Polosa, Professor of Internal Medicine at the University of Catania (Italy) and Founder of the Center of Excellence for the Acceleration of Harm Reduction (COEHAR) believes that “the authors are presenting a case devoid of scientific evidence.”

The Lancet piece dates back the “EVALI” cases – lung diseases that occurred last year in the United States (US) and the presence of vitamin E acetate in cartridges containing illegal cannabis and not linked to e-cigs at all. However, the article suggests the idea that the causes of the diseases could be “multifactorial”: not exclusively related to the vitamin E acetate, complaining that Centers for Disease Control (CDC) in the US has stopped publishing updates on the issue

Ricardo Polosa

“The authors are presenting evidence that is devoid of science,” commented Prof. Polosa. “It is well known that EVALI has nothing to do with commercially available nicotine vaping products and there is no increased risk of a COVID-19 diagnosis among those who vape.” Prof. Polosa said there are tens of major studies using hospital and community cases, cross-sectional and follow-up designs from China, Italy, the United Kingdom (UK), the United States (US) and Israel have shown that current smokers have a lower risk of Covid-19 disease, hospitalization and Intensive Care Unit (ICU) admissions.

As a matter of fact, says Polosa “…not even deadly smoking is a risk factor for COVID-19 hospitalization as recently shown in a large meta-analysis of > 6500 cases. Incriminating vaping products no matter what is becoming a new US national sport. The credibility of the scientific community is at stake.”

Derek Yach physician epidemiologist who is President of the New York (USA)-based Foundation for a Smoke Free World (FSFW) is critical about the association between Ecig, EVALI and Covid-19. He believes that the current epidemiological and laboratory evidence shows that e-cigs were unrelated to the US epidemic of respiratory disease in young people and that e-cigs are extremely unlikely to be related to Covid-19 incidence.

He recalled how vaping was not the cause of lung diseases and the culprit should be the cartridge containing Tetrahydrocannabinol THC sold illegally as confirmed in the declining phase of the epidemic by the CDC and the Food and Drug Administration (FDA).

Derek Yach

“A recent major detailed review of the “EVALI” outbreak by a sophisticated data analytic group, showed that e-cigarettes were not the cause of the respiratory outbreak seen in young people,” says Yach.

“Rather, it was caused by contaminated THC cartridges sold illegally. The truth though was only confirmed in the waning phase of the outbreak by the CDC and FDA and after NGOs, youth-activists, media and politicians had convinced themselves that the alleged “cause”, e-cigarettes and especially JUUL, demanded regulatory action, public warnings re the dangers of vaping and demonization of harm reduction. “

The result says Yach is bad policies that are increasing combustible cigarette use and leading the public and policy makers to believe that nicotine and vaping are causes of cancer.

“They are not. Distorted public perception combined with weak basic epidemiological methods has now played out with the latest study on COVID-19 and vaping. Detailed critiques have shown that this is a spurious association not supported by the data (one reference is cited below).

Yet, as with the EVALI episode (as referred above), politicians are jumping onto it and using the concerns raised by this faulty study to call for a national vaping ban. Sadly, this too will simply reinforce smoking as a less harmful desired behavior,” Yach says.

The article was first published in Italian SIGMAGAZINE

The English version was posted in CoEHAR

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