Huff & Puff

So there’s a new quack in town that has decided to jump on the anti-vaping bandwagon. Is this quack a respiratory physician? A specialist in the deep, dark and mysterious ways of the lung and airway? A specialist in the effects of cancer or other diseases that have been linked with smoking?

No. Margaret Cuomo (MD) is a radiologist. She specialises in diagnostic radiology. She has published a book – “A World without Cancer” – which (according to Amazon) is fairly popular. I haven’t read it, based on her latest stunt for Huff Post Wise it’s likely to be filled with inane, non-evidence based drivel. But what do you expect? The eldest daughter of _former New York Governor _Mario Cuomo and former NY First Lady Matilda. The sister of Governor Andrew Cuomo and CNN’s Chris Cuomo seems to give her the idea that she can say anything she damn well likes.

Being a radiologist makes her as much an expert on e-cigs as being an aeronautical engineer does, that is to say not at all.

There is a short (2 minute) video over on HuffPo (I am not going to link it) entitled – Why E-Cigarettes Are Just As Dangerous As Tobacco Cigarettes – presented by our new evidence free quack. It also appeared on Facebook for a while, and last I checked it had a few hundred comments before being pulled. Maybe the editor or social media manager saw posts from VapingIT and ThaumaturgeRN and decided to pull it to preserve any sense of credibility.

As an MD you’d expect there to be some evidence base for the things that Cuomo decides to spout in a video hosted on a popular platform, but no.

Big opening statement that. You see, whenever anyone says chemical it immediately raises red flags in most folk. Thing is everything is made of chemicals, some natural and some synthetic. This is plain and simple propaganda, aimed to create confusion and sow the seeds of doubt. Conflating the “risks” of e-cigarettes with tobacco is just plain daft, none of the 200+ studies have highlighted that when used properly, e-cigarettes are as harmful as tobacco. Ignoring the widely recognised 95 percentile figure for a moment, studies have identified some nasties but in levels that are unlikely to have any biological effect.

So the opening statement by Cuomo is deliberately misleading. Why am I not surprised.

More misleading information. Formaldehyde is present in normal human breath it is created through our metabolism. Surely an MD would know that, or you would think so. Formaldehyde is also present in tobacco smoke, at significantly greater quantities than found when an e-cigarette is used in _dry puff conditions. _As far as I know benzene hasn’t actually been found in e-cig aerosol.

I don’t know why she is suddenly so concerned about propylene glycol, after all it’s used in air-conditioning for hospitals, it’s inhaled by thousands of people daily. Though she is incorrect in that it is found in cigarettes, as are the metals she mentions.

When you get right down to it, anything can be linked to cancer, you’ve seen the ridiculous California Prop65 list which lists a whole host of chemicals “known to the State of California” to cause cancer or birth defects. I wonder when walking will be added.

I’ll admit it. I snorked at these two statements. There is some truth to the first, after all e-cigarettes aren’t completely risk-free, but let’s be honest the chances of developing cancer from e-cig use is so minimal it may as well be non-existent. That doesn’t mean to say that a combination of circumstances (and maybe some bad luck) may lead to a vaper developing lung cancer, but that is likely to be more a result of the normal air we breathe than vaping, after all there’s a lot of pollutants in the air we breathe daily – as Marcus Munafo put it at the E-Cigarette Summit – he probably inhaled more toxins on his walk from the station to the summit than a vaper does vaping.

There are many reports of asthmatic vapers having decreased their dependence on their inhalers, reports of COPD sufferers having better lung function. There’s even indications of _harm reversal _in general and in asthmatics in particular.

I guess that Cuomo believes that vaping is smoking when making these statements.

I did wonder when the good doctor would get around to the marketing aspect, so I asked for examples of e-cig adverts. This is what Shannon found:

<a class="wp-block-jetpack-slideshow_button-prev swiper-button-prev swiper-button-white" role="button"></a><a class="wp-block-jetpack-slideshow_button-next swiper-button-next swiper-button-white" role="button"></a><a aria-label="Pause Slideshow" class="wp-block-jetpack-slideshow_button-pause" role="button"></a>

<div class="wp-block-jetpack-slideshow_pagination swiper-pagination swiper-pagination-white">
</div>

Now unless I’m completely blinkered, I can’t see any of these examples being directed at The Children™ yet Cuomo makes out that because e-cigarette use has “tripled” it’s a bad thing. The thing is she misses the point, as most of them do, that wherever teen e-cig use is on the rise traditional tobacco use is in decline. In fact, tobacco use is declining faster now than it has in years. Can we attribute that solely to e-cigarettes? Doubtful as there have been other measures implemented over the years (bans, tax hikes, plain packaging – and no Simple Simon, plain packaging does not work you dunderhead) but we can determine that e-cigarette use is a positive factor in the decline.

E-cigarettes are a public health benefit anyone can see that just by comparing smoking prevalence from 10 years ago to today, to say otherwise is foolish not to mention harmful to the health of the public.

See, this is where I will vehemently disagree with proposed regulations. Why on earth are policy makers restricting harm reduction products to over 18’s only? In this case, I will 110% agree with Dave Dorn as I have made a point of writing about in the past.

Here’s the thing, this quack has been tweeting this link to a host of individuals:

This video, and the doctor that features in it is wilful misinformation. There isn’t any evidence to back up even one of the claims made which are all basically “think of The Children™” type arguments – high levels of e-cig use in teens so it must be a bad thing, well bollocks. The vast majority of these Children™ are (or rather were) smokers anyway, and folks like this deranged doctor are sowing the seeds or doubt and mistrust in a product that has, and continues to lower the smoking prevalence rates worldwide. Public confidence in the product has never been lower, and you can lay the blame for that squarely at the doorstep of folk like this doctor.

Perhaps the good doctor would like to re-read the Hippocratic Oath:

I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.

I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.

With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.

Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.

Further, I will comport myself and use my knowledge in a godly manner.

I will not cut for the stone, but will commit that affair entirely to the surgeons.

Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.

Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.

If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!

This doctor, by making this video and the statements contained therein will cause injury or wrong from the falsehoods that she has portrayed. This isn’t a simple case of misjudgement, this is blatant lying, but of course opponents of harm reduction in general and e-cigarettes in particular are no strangers to lying to get their way.