Public health experts urge US officials to correct e-cigarette misinformation

Leading e-cigarette researchers have urged the US Centers for Disease Control & Prevention (CDC) to correct misinformation overstating the dangers of e-cigarettes.

A group of public health experts from five major US universities along with the attorney general for Iowa have published an editorial in the journal Addiction drawing attention to how the CDC and US Surgeon General perpetuate misinformation on e-cigarettes. They ask the CDC to take concrete steps to address and correct the errors, and thereby strengthen its reputation.

The authors identify the CDC’s handling of the late-2019 outbreak of lung injuries attributed to vaping products as one problem. While these lung injuries are now known to be caused by Vitamin E Acetate added to illicit marijuana vapes, the CDC continues to use an outdated, inaccurate naming convention for this disease — E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) — that does more public health harm than good.

“Smokers are still twice as likely to incorrectly identify e-cigarettes as the cause of a serious lung disease outbreak in 2019 than to correctly identify marijuana vape products contaminated by Vitamin E Acetate as the cause,” said Professor Michael Pesko of Georgia State University, lead author.

“Because many smokers then falsely believe e-cigarettes to be as or more dangerous than cigarettes, the misinformation reduces smoking cessation that would otherwise occur. Population health suffers as a result.”

The experts say part of the problem arises from misunderstanding of what electronic cigarettes are.

“A THC-containing vaping device is no more an e-cigarette than a joint containing cannabis is a cigarette,” said co-author Jonathan Foulds of Penn State College of Medicine. “We recommend the CDC provide a simple definition of these products. ‘An electronic cigarette is a product that transforms a liquid containing nicotine into an aerosol that is inhaled via a mouthpiece.’ This definition would avoid the recent confusion regarding devices using other drugs.”

The authors also ask the CDC to correct misinformation regarding the role of e-cigarettes in youth cigarette use.

“Misinformation from the Surgeon General’s website that implies e-cigarette use causes young people to become smokers is not consistent with the evidence,” explained co-author Cliff Douglas of the University of Michigan. “While youth e-cigarette use peaked in 2019, youth smoking recently dropped to historically low levels, below 2 per cent.”

“We have a lot of respect for the work of the CDC and the Office of the Surgeon General,” said Pesko. “But in order to reverse the trend of declining trust in public health institutions, it is important that they publicly update their statements or recommendations when significant new evidence becomes available.”