Misinformation around approaches to tobacco harm reduction continues to generate confusion and possibly contribute to the disease and death associated with the use of combustible tobacco products. In a recent ABC News article, the author suggested that U.S. physicians are discouraging the use of electronic nicotine delivery systems—products more commonly referred to as e-cigarettes or vapes. The information included to support this thesis, however, was at best cherry-picked—chosen to give the appearance of validity—and at worst incomplete, outdated or entirely false.

The first point of misinformation in the article is the assertion that recent guidelines published by the American College of Cardiology strongly discourage the use of e-cigarettes. Importantly, the guidelines mentioned in the article are designed to provide physicians with information to manage patients with chronic coronary disease (CCD); they are not applicable to the care of the general population that does not have CCD, although the article inferred that they were. Additionally, the guideline recommendation related to smoking cessation and e-cigarettes is more measured than the ABC News article implies. Specifically, the guideline advises: “In patients with CCD who regularly smoke tobacco, the short-term use of nicotine-containing e-cigarettes may be considered to aid smoking cessation, although the risk of sustained use and unknown long-term safety may outweigh the benefits.” Other scientific literature provides more clarity on the relationship between CCD risks and smoking compared to the use of alternative sources of nicotine.

The second point of misinformation in the news article is related to the use of e-cigarettes as smoking cessation aids. The article quoted two physicians who suggested that there may be better and more powerful options (nicotine replacement therapy [NRT] or pharmacologic medications) to help smokers quit. Unfortunately, these statements do not align with what is currently understood and supported by multiple scientific studies. E-cigarettes have been shown to improve quit rates for those who smoke combustible cigarettes and want to quit over traditional NRTs. And while it is true that no e-cigarette has been approved for smoking cessation by the U.S. Food and Drug Administration’s (FDA’s) Center for Drug Evaluation and Research, several e-cigarettes have received marketing orders from the FDA’s Center for Tobacco Products (CTP), which suggests that they have reached the CTP standard of being “appropriate for the protection of the public health.” There is also mounting evidence that switching from combustible cigarettes to e-cigarettes significantly reduces the health risks associated with smoking.

The third point of misinformation in the article is related to incorrectly associating e-cigarette use with a disease known as e-cigarette or vaping use-associated lung injury (EVALI). Several years ago, the Centers for Disease Control and Prevention (CDC) tracked an outbreak of EVALI syndrome that began in 2019. Over a two-year period, 2,807 people were hospitalized with severe respiratory symptoms, and 68 deaths were attributed to EVALI. Initially, the CDC and other health organizations linked this outbreak to e-cigarettes because of the increased use of e-cigarettes during the same period. However, we now know that EVALI is strongly linked to vitamin E acetate, an ingredient found in some THC-containing vaping products. Unfortunately, the incorrect cause of the disease was widely communicated at the time of the outbreak, and the updated, correct information was not broadly shared, although it can now be found on the CDC and FDA websites.

Taken together, these three points of misinformation suggest that the ABC News article is misleading at best. All individuals should have the right to accurate information so they can make the best decisions for their own health. When media outlets sensationalize topics to drive clicks and views, the only positive outcome is additional ad revenue for the news agency, which should never be prioritized over the health of their readers.

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