U.K. Cancer Study Research On Vaping

Welcome once again to another edition of 'Other Countries Understand the Benefits of Vaping!' Today, we're going to visit a study published in *Annals of Internal Medicine*. Despite being described as 'the flagship journal of the American College of Physicians,' the second-largest physician group in the United States, the study at hand has seen little press stateside.

Earlier this month, a group of researchers released their findings from following a group of individuals in the UK, evenly divided between smokers, vapers, users of nicotine replacement therapy (NRTs, i.e. 'the patch'), and smokers who also used either vapor devices or NRTs.

The findings, while unsurprising in the vape community, would be epic in proportion if picked up by the mainstream media. The technical language:

*After confounders were controlled for, no clear between-group differences in salivary or urinary biomarkers of nicotine intake were found. The e-cigarette–only and NRT-only users had significantly lower metabolite levels for TSNAs (including the carcinogenic metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL]) and VOCs (including metabolites of the toxins acrolein; acrylamide; acrylonitrile; 1,3-butadiene; and ethylene oxide) than combustible cigarette–only, dual combustible cigarette–e-cigarette, or dual combustible cigarette–NRT users. The e-cigarette–only users had significantly lower NNAL levels than all other groups. Combustible cigarette–only, dual combustible cigarette–NRT, and dual combustible cigarette–e-cigarette users had largely similar levels of TSNA and VOC metabolites.

* Translation:

Researchers found that despite consuming comparable amounts of nicotine, considerably lower levels of carcinogens in the urine and saliva of NRT and e-cigarette users, as compared to smokers or dual-users. People who had been vaping exclusively for six months or more showed the lowest level of measurable carcinogens in their systems, performing even better than exclusive users of other tobacco alternatives such as nicotine patches or gum.

The study, funded by the broadly-focused *Cancer Research UK*, received considerable coverage across the pond, including a nod from National Health Service, the government-funded healthcare system that serves all of England.

In the US, however, *CBS News* was the only mainstream source to give the study significant attention. Their conclusion, drawn from the American Lung Association and the US Centers on Disease Control, is focused on the point that many vapers are 'dual users,' who didn't receive the same benefit as did those who quit smoking completely.

This much is obvious: if you smoke but also vape, you're still a smoker. A self-professed healthy food enthusiast who eats a daily breakfast of fruit and granola followed by two trips to a fast food restaurant for lunch and dinner isn't going to realize the same benefits as another person who fully embraces a healthy diet all day.

We'd love to see everyone who tries vaping immediately and fully convert, throwing out their cigarettes and lighters on the first or second day of the transition. But that's not how it works. A better way, we think, to frame this study would be to point out the benefits of switching to people who are on the fence – those very ones who own a vaping device but still smoke might be pushed to vape even more and smoke even less if they were presented with evidence that such habits really do improve health and save lives. Instead, we get statements like 'If you want to stop smoking, you may as well use an FDA-approved nicotine replacement, such as the patch or the lozenge. You can have more confidence because it’s been analyzed by the FDA,' from the likes of Dr. Norman Edelman of the American Lung Association.

If Dr. Edelman was truly interested in improving public health, might he instead take the opportunity to give hesitant vapers a push, reminding them that not only are they improving their own health, they're virtually eliminating secondhand exposure risk to others around them? Perhaps a push directed at the FDA to step up its research game is in order? It seems the rest of the world, even according to our own medical journals, seems to be coming down on the right side of history while the US remains stuck in the mud.