The weird effects of public health

It seems that when there is a slow news day various entities resort to conjuring up the weirdest of headlines, almost to the point of actually making stuff up.

Although in this case the studies do actually exist and have come out of the American Thoracic Society conference, which is pretty unbalanced towards any and all negative attitudes towards personal vaporisers.

Using e-cigarettes suppresses your ability to cough

CoughReflexSensitivityUh, OK this is by far the weirdest one of the lot. To be fair, the lungs are impressive pieces of biological hardware. Foreign objects are forcibly expelled from them via the cough. This is one of the main reasons why smokers have the cough first thing in the morning, it’s the lungs desperately trying to self-clean all the rubbish that has been inhaled and scrubbed during the sleeping hours, only for said smoker to inhale more stuff later.

The trouble with the study being referred to is two-fold.

First and most obvious is the sample size. A grand total of 30 subjects, 15 of which were female so we have a 50/50 split. The cough reflex, which can be tested with a reasonable degree of accuracy does in fact vary wildly in different people. Some may cough easier, some may not.

Secondly, the study focuses on non-smokers only. For any safety concerns about vaping to be conclusively put to bed, surely the focus of any study should be on those that are most likely to use the devices. The smokers in other words.

The only conclusion I can draw from this, is that non-smokers shouldn’t be taking up vaping. But we knew that anyway. Like I said, a slow news day.

E-cigarette flavors may have different effects

FlavoursInLungs Now, we know that certain flavourings are not good at all for inhalation. But we also know that flavours are a big key aspect for keeping us away from traditional tobacco.

Again, we are faced with yet another study on flavours that claims they are “bad”. Trouble is, it is yet another study that does not reflect actual usage. At all.

Instead of exposing the epithelial cells to the actual vapor, as Dr Farsalinos has done in the past, they exposed the cells to the actual liquids themselves.

I don’t know about you, but that seems to be totally pointless unless you are inhaling the liquid itself, which would just be plain stupid. It does seem a little strange for the study authors to specifically highlight “Banana Pudding (Southern Style)” as one of the flavours that “evoked a strong response”. What is the difference between “Banana Pudding” and the “Southern Style”?

Evidence is growing that e-cigarettes probably aren’t an effective way to quit smoking

SmokingCessationThis is one that spread a little further than the rest, but isn’t actually a study in its own right. It is in fact an analysis of existing data.

As with the other studies to come out of the ATS Conference, there is clear indication of bias:

“Studies of efficacy were included if they enrolled current smokers and compared e-cigarettes to placebo, active control or no therapy. Studies of safety were included regardless of design if they reported any adverse events associated with e-cigarette use

In two short sentences, the authors of the analysis are showing their bias in reporting on anything negative associated with e-cigarette use. True we do want to know about any safety concerns, but what this analysis clearly shows is that with regards to safety the only aspect public health are concerned with is over-exaggerating any negatives.

Out of the 4569 studies checked, only abstract not the full text by the way, the authors selected 297 for full text review. Out of those 297, only four were selected for efficacy.  For safety, 22 articles met the inclusion criteria. Makes me wonder which studies were actually selected, and exactly what criteria determined the selection. So I sent the lead author and e-mail requesting just that information.

After several hours of not receiving a response, I found the authors twitter account.

TwitterRequest

I’ll bet you know what kind of response I got don’t you?

tumbleweed

 

But of course, I forget one important detail.

Mentor

Absolutely zero chance of being listened to then. Just another day as an advocate.

  • Just a couple notes to add to a well done piece:

    The cough reflex may be desensitized by the very medium used to stimulate the coughing in the first place: http://www.ncbi.nlm.nih.gov/pubmed/25468411

    The Cochrane Review is still the only neutral systemic review and shows positive though cautious affirmation that e-cigarette use does help smokers quit or reduce the use of combustible tobacco. Their selection process is standardized while the cited study fails on all points as you rightly pointed out. http://www.ncbi.nlm.nih.gov/pubmed/25515689