A review conducted by researchers at the Center for Tobacco Control Research and Education at the University of California and published in the Lancet Respiratory Medicine Journal, received plenty of media coverage this past week, with the Daily Mail using the study to run with the headline "E-cigarettes WON'T help you quit,” – maybe you spotted it?
But now, after scrutiny from respected scientists and experts, the study has received huge amounts of criticism, with even those whose work was used in the study - labelling it either 'inaccurate' or 'misleading'.
The debate centres on three main points of contention:
Firstly, the research uses the umbrella term 'e-cigarette' to judge the whole category. As we all know there are many different types of electronic cigarettes, from large devices as big as a smartphone, right the way through to the Gamucci Micro, these devices are all different - and according to Professor Linda Bauld, Professor of Health Policy at the University of Stirling, many of the papers included in the analysis don't specify which type people are using.
This is made even more important when you consider the varying quality of e-cigarettes available to purchase.
For example, research conducted by the German Cancer Research Centre found that Gamucci was vapourised nicotine most consistently and effectively of 16 of the most popular e-cigarette brands. A Gamucci electronic cigarette vapourised 70% of the nicotine within the cartridge very effectively and very consistently; whereas a generic electronic cigarette was only able to vapourise 30% of the nicotine into the vapour, and in doing so widely fluctuated between very high amounts of delivery, to almost no delivery of nicotine.
Therefore, by using a blanket approach to the whole category, the study neglects the fact that there is a large disparity in both the quality of devices from recognised brands, and the user experience from the many different type of devices.
Secondly, Professor Bauld outlines that the review uses contrasting studies to reach its much publicised conclusion, "Some [studies] only assessed whether a person had ever tried an e-cigarette or if they had tried one recently, not whether they were using it regularly or frequently," This was even acknowledged by one of the paper’s authors Professor Stanton Glantz, who presented that “in some of the studies e-cigarettes may only have been used once, which he says would not be a good predictor of whether they had affected people's ability to stop smoking.”
Lastly and most importantly, one might expect a study that is seeking to assert a conclusion on whether e-cigarettes help smokers stop might assess if those who were using e-cigarettes wanted to infact move away from tobacco; however according to Professor Robert West, head of a team at the University College London, this analysis “mashed together some very different studies - only some of which include people using e-cigarettes to help them quit.”
"To mix them in with studies where you've got people using an e-cigarette and are not particularly trying to stop smoking is mixing apples and oranges," he states. This study even used research seeking to track the use of electronic cigarettes on people who use e-cigarette for other reasons – such as whilst working to avoid leaving the office, or in a bar – spaces where smoking is typically banned.
"With the studies where people are using electronic cigarettes specifically in a quit attempt the evidence is consistent," says West.
West's investigation follows people in their daily lives and assesses how successful various methods of giving up smoking are - this includes nicotine patches, medicines and going cold turkey. These studies suggest that people using e-cigarettes to help them quit are 50% to 100% more successful than those who use no aids at all.
Furthermore, Ann McNeill, who is the professor of tobacco addiction at Kings College London, and whose own research is included in study analysis, has written her own response on the Science Media Centre website where she argues that "This review is not scientific"
"The information… about two studies that I co-authored is either inaccurate or misleading… I believe the findings should therefore be dismissed. I am concerned at the huge damage this publication may have - many more smokers may continue smoking and die if they take from this piece of work that all evidence suggests e-cigarettes do not help you quit smoking; that is not the case."
Prof Peter Hajek, director of the Tobacco Dependence Research Unit at the Wolfson Institute also called the findings "grossly misleading".