The Credibility of the World Health Organization on Vaping

The Credibility of the World Health Organization on Vaping

In a time when all eyes are on the World Health Organization to track and report on the novel coronavirus (2019-nCoV), many people are questioning whether the WHO has squandered its credibility. The WHO has already made its antipathy to nicotine vaping clear. Even with strong evidence that vaping displaces smoking at a substantially higher rate than traditional nicotine replacement therapies (NRTs) and is significantly less harmful than combustible cigarettes, the WHO remains resistant to the technology, to an embarrassing extent. But their most recent release had experts and laypersons around the world join in a collective eye roll. 

They could have taken a subtler approach and still pulled off the false narrative they were aiming for but instead they went with full out bad acting. Among the statements on the World Health Organization’s site they claimed there is growing evidence to suggest a link between electronic nicotine delivery systems (ENDS) and lung injuries, citing cases investigated by the CDC in the United States which had long since been linked to the use of THC cartridges cut with vitamin E acetate (a real health crisis that the WHO might have but didn’t concern itself with). If that was too fine a point to panic the public they went on to claim that second hand vapor is dangerous because ENDS “contain toxic substances, including glycol which is used to make antifreeze.” Scary stuff. Except that glycols are a class of organic compounds. The specific glycol that the WHO wants you to think about is ethylene glycol, which can be poisonous (especially to pets who may be drawn to the sweetness of leaked antifreeze) and is not contained in nicotine e-liquids. Propylene glycol, the glycol that is contained in nicotine e-liquids is food grade and present in everything from cosmetics to whipped dairy products, ice cream, pharmaceuticals, etcetera. It is also present in some antifreeze to replace ethylene glycol for a less toxic, more environmentally friendly option.[i]

Response from the scientific community was swift and cutting. Science Magazine, Science Media Centre, and Filter Magazine among numerous other sites published critiques from around the world. Among the many respondents, Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University of London wrote, “The WHO has a history of anti-vaping activism that is damaging their reputation. This document is particularly malign. Practically all the factual statements in it are wrong.” Director of the UK Centre for Tobacco & Alcohol Studies, Professor John Britton asserted that the “WHO misrepresents the available scientific evidence.” Louise Ross, former manager of the Stop Smoking Service in Leicester, England, whose work was recently highlighted in the Netflix program Broken (episode two) stated, “I’m already getting calls from healthcare professionals who now think that vaping is more dangerous than smoking, because of the WHO report that misleads and confuses. I’m so angry that this will increase the numbers of people who continue to smoke or go back to smoking because they have been misinformed by an organisation that claims to care about health.”

David Sweanor, adjunct Professor of Law at the university of Ottawa, Ontario has said, “To say that e-cigarettes are not safe is as accurate as saying the same about seat belts, condoms, sterile syringes, sanitary food and clean drinking water. Nothing is absolutely safe. But for the WHO to use such sophistry to mislead the public on relative risks compared to the likely alternative is negligent and deadly.” Marewa Glover of the Centre of Research Excellence-Indigenous Sovereignty & Smoking in New Zealand asserted that, “Millions of people around the world have stopped smoking thanks to the mass exodus from combustible cigarettes to vaping, snus and tobacco heating devices. They, and the many thousands of health professionals and family members who are observing and supporting this lifesaving transition know how very wrong the WHO are in their anti-tobacco harm reduction stance.”

Clive Bates, former Director of Action on Smoking and Health in the UK and current director of the Counterfactual, dedicated an extensive article countering each of the WHO’s claims one by one, examining financial ties of the WHO, and finishes with recommendations on how the WHO should proceed if it wishes to recover any credibility.[i] 

All of these criticisms were welcomed by the vaping industry and former smokers who have quit smoking through vaping. Though the claims don’t require a scientist to dispute them any pushback from the industry or end-users is generally taken as self-serving and largely disregarded, even when backed by verifiable evidence, while claims against vaping, however outlandish, are taken at face value. The mainstream media rather predictably did not pick up on the story, though it should have been news that the WHO (a highly respected, international health organization) had released such a laughable and easily fact-checked Q & A page on its site.

There is nothing inherently wrong about members of the WHO having personal feelings about the files that they work on. The harm comes when personal feelings and bias interfere with the factual reporting of health issues to the public. Not only is there the potential for direct harm, as may come from the WHO’s directive on nicotine vaping, but of loss of trust in the organization and so refusal to heed real warnings. In a world where trust in authorities is a rare commodity, it should not be squandered. We need only look to the rise in anti-vaxxers and the consequences to public health to see how serious the repercussions can be. The WHO should be careful not to cry wolf too frequently, as should other public health authorities with a personal agenda.

[1]  The WHO has since removed this statement and just gone with a generic ‘yes’ to second hand vapor being dangerous. “The aerosols generated by ENDS typically contain toxic substances. ENDS pose risks to both users and non-users.” No mention of what toxic substances they may be referring to.

[2] I would highly recommend reading Clive Bates’ article, World Health Organisation fails at science and fails at propaganda - the sad case of WHO's anti-vaping Q&A, in full on the Counterfactual website.