Researchers Call Out the Lancet Oncology on Misleading E-Cig Editorial

By Lindsay Fox Posted December 5, 2013

Prof. Riccardo Polosa and Dr. Pasquale Caponnetto have had a letter published in the Lancet Oncology this month, after having spotted the sort of editorial you’d expect to see in a misguided tabloid rather than a prestigious journal. In the original editorial, the journal referenced the now-infamous CDC e-cig survey, which claims a doubling in e-cig use among teenagers, and used this flawed data to justify their statement that e-cigs are “becoming a gateway product, attracting more young people to begin smoking.”


Prof. Polosa and Dr. Caponnetto did what we need researchers to do when confronted with similarly flawed arguments, especially when it comes from such a respectable source; they politely explained why the data did not support the conclusion that e-cigs are a gateway to smoking. Most importantly, the study classed anybody who’d had even a puff of an e-cig in the past month as a “current” vaper, making the measure largely one of recent experimentation, not regular use. The study also didn’t find a single teen who started vaping then moved on to regular smoking.


In addition, the pair point out that the allegation made in the editorial, that “e-cigarettes also pose a serious danger of renormalizing smoking” is entirely unsupported by evidence, and that almost everybody can easily distinguish between the two. They also point out the safety of e-cigarettes according to existing research and accepted safe exposure limits of inhalable chemicals. The letter closes with a look at regulation, arguing that it’s prudent to take steps to ensure that children or non-smokers don’t start vaping in significant numbers in the future, as well as suggesting reasonable manufacturing processes to ensure e-cigs don’t contain excessive amounts of impurities or contaminants and that they’re accurately labeled. It’s stressed in the letter that medical regulations would detract from the appeal of e-cigs and make the price less competitive in comparison with tobacco cigs.


To conclude, Prof. Polosa and Dr. Caponnetto argue that present data indicates that regulators, public health officials and anti-smoking groups should embrace e-cigarettes, before turning their attention back to the original editorial, “It is irresponsible to mislead the public into believing that e-cigarettes pose an extraordinary danger to consumers and young people when there is absolutely no evidence to support that claim.”


Prof. Polosa and Dr. Caponnetto produced a fantastic letter, but it’s important that the Lancet Oncology is recognized for their willingness to tacitly admit their error by publishing the letter. Being wrong isn’t nice, but we can all do it from time to time, even respected medical journals. This decision deserves praise because it shows that the Lancet prioritizes science and reason, rather than blindly adhering to a senseless ideology and twisting data to fit that purpose. Of course, any respectable journal should do the same, but it’s good to know that the physicians and researchers who read the journal will be exposed to the scientifically-informed, rational view of e-cigarettes, and will hopefully mentally file the previous editorial under the category of “sensationalist nonsense.”

  • Henry Louis

    Well done Professor Polosa and Professor Caponnetto for refuting so beautifully the ambiguous report. Even if a person ends up smoking after his first nicotine experience (which might suggest gateway use), it is likely that the individual would have ended up smoking regardless of the role ecigs might have played. If you look at it from another point – individuals can experiment with nicotine with the help of ecigs without getting hooked to it.

    So, according to me, ecigs are not a gateway to smoking nor do they entrap users in the grip of nicotine addiction in the way analog cigarettes do. It is nothing less than a scare tactic to keep smokers away from switching.