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Formaldehyde Redux

Once again it seems that some in the scientific community feel that they have a mission to discredit vaping. Another “medical” study has appeared, fretting over formaldehyde, and using laboratory techniques that do not approximate the conditions of actual vaping.

Formaldehyde is a common substance in the atmosphere, as it is naturally produced by a number of everyday chemical processes and reactions. It can be dangerous at high concentrations and if ingested in certain ways, like many things you have around your house. Some of its uses include preservation of organic tissue, so it is used, for instance, in embalming fluid. Remember that funny smell in the biology lab? That was formaldehyde. If it were mortally dangerous to be in a space where you can smell formaldehyde, many biology teachers would be lying dead in their classrooms, not to mention funeral directors.

The burning of tobacco produces a great deal of formaldehyde. A dangerous level (but you can't detect that nasty smell because of all the other toxicants the smoke is pouring into your body). The inhalation of vapor from the heating of propylene glycol laced with nicotine produces traces of formaldehyde.

A group of scientists has managed to produce high levels of formaldehyde from such vapor, higher than the level produced by burning tobacco, by heating the vapor to extreme levels in laboratory machines (not in vaporizers used by humans), levels much higher than those produced by actual vaping by humans. The report of their study has appeared in a medical journal, and claims to demonstrate that vaping is dangerous.

The article has produced outraged responses from prominent, and scientifically well informed, voices in the harm-reduction community, including cardiologist Konstantinos Farsalinos, Bill Godshall, who heads Smokefree Pennsylvania, Greg Conley, President of the American Vaping Association, and Clive Bates, former head of Britain's Action on Smoking and Health, whose blog “The Counterfactual” is known for its trenchant commentary.

Farsalinos notes that the electrical power levels administered were reported in terms of voltage rather than wattage, information which yields no information about “thermal load”. His own lab calculated the wattage that would be required to produce the reported levels of liquid consumption, and found the thermal load to be far higher than any commercially available vaporizer. A “mod” (a vaporizer that a user has tinkered with) could produce it, but the tinkerer would reject the result, as it would taste horrible. This is equivalent to the “dry-puff-phenomenon”, and all of the harm-reduction commentators mentioned it.

Farsalinos also notes that the study did not find actual formaldehyde, but a type of “formaldehyde-releasing agents” called hemiacetals, and that the researchers referenced their comments with data on hemiacetals that produce contact dermatitis, not the ones found in vapor. Hemiacetals themselves, Farsalinos notes, have not been shown to be carcinogens. The researchers simply assumed that they would generate carcinogenic formaldehyde, and reported that “finding” without support.

Bates asks the researchers: “Can you provide a citation to support this assumption, given that the attention-grabbing findings in the letter rest entirely on it? As you will be aware, formaldehyde-releasing preservatives are used as an alternative to formaldehyde in many preparations for safety reasons.”

Godshall compares this research with a study on low-tar cigarettes, produced by Big Tobacco way back before the Master Settlement. The research was conducted under unrealistic conditions, and “found” that low-tar cigarettes were reduced-harm products. They weren't. That study claimed to exonerate a harmful product; this one attempts to incriminate a relatively benign one.

The study estimates the lifetime increase in cancer risk to be 5-15 times higher than that produced by smoking, and Bates notes that, even if true, this would apply only to that portion of the risk produced by formaldehyde, while burning tobacco furnishes hundreds more toxicants that are not found in e-cig vapor.

Bates concludes, in his open letter to the researchers, available on the Counterfactual: “Studies like this and the reporting that has followed, are gradually persuading smokers that e-cigarettes are much more risky than they are, and that they might as well continue to smoke.” Noting that studies show a 20% reduction in public confidence that vaping is not as dangerous as smoking, he adds: “This is a trend that should shame the public health community and the academics that are fuelling consumers’ misunderstanding with misleading studies that misrepresent risk.”