Lab conditions make all the difference
The study presented recently at the American Society for Cancer Research (and earlier this year at another conference), and reported in the highly esteemed scientific journal Nature (in which bronchial cells treated with a medium impregnated with nicotine from e-cig vapor exhibited genetic change and cell growth comparable to that observed when the nicotine was from cigarette smoke) has been causing some concern among vapers.
When asked about the study on his Facebook page, noted nicotine and e-cig scientist Konstantinos Farsalinos of the Onassis Research Center in Belgium commmented: "It is just a cell study which seems to incriminate nicotine. There is no evidence from human epidemiological study that nicotine causes cancer, that is why it is not officially a carcinogen..."
What is "epidemiology" and why does that make a difference? Epidemiology is "the science that studies the patterns, causes, and effects of health and disease conditions in defined populations." An epidemiological study looks at actual diseases, not just at what happens to cells in lab dishes. This is not to say that cell studies cannot be useful. They can. But before raising danger signals on the basis of laboratory cell studies, it is crucial to make sure the conditions are comparable to real life conditions. Otherwise, the fears aroused by such studies are bogus.
It would seem that the recent study in question, and its reporting in the press, are driven by a wish to find dangers in e-vapor, and to use unjustified fears to sway opinion in the current political controversies about vaping. The design of a research study is all important. Says Farsolinos: "I’ve seen experienced labs making huge methodological mistakes when we gave them an e-cigarette to test. It’s very important to know what you’re doing, because at a laboratory level it’s extremely easy to misuse them and produce useless unrealistic results.
If the tests don’t represent the way the product is used by vapers, then what is the point?
For example, Farsolinos himself recently studied "cytotoxic potential of 20 different e-cigarette liquids (in vapor form) on cultured cardiac cells." The type of cells examined was different – it was heart tissue rather than bronchial tissue – but the issues involved were the same. A vital difference was that the chemicals were investigated as they would occur in real life, by contrast with the study quoted in Nature, which used a "medium" impregnated with nicotine from e-vapor. (In this it was similar to a study reported out of Brown University last Fall, which managed to produce tumor-like symptoms in cardiac tissue by administering liquid nicotine in lab dishes.)
The cardiac study by Farsalinos "reproduced real-life use of e-cigarettes." Of course cell damage can be induced in a laboratory using virtually any substance, administered under abnormal conditions. Use of data from such studies (in this instance a conference paper, not yet peer reviewed and far from publication or confirmation by other scientists) in the press, to sway opinion, is a highly suspect journalistic practice. Even the unreviewed study's conclusions are not as damaging as implied, since what was shown was two things that can be, but are not necessarily, tumor components: cell growth and genetic mutation.
Here is one further note of interest to those following the work of Konstantinos Farsalinos. His new population study giving a world survey of e-cigarette use in relation to smoking cessation, completed and submitted for publication last February, has been accepted by the International Journal of Environmental Research and Public Health, and should be available soon.
Congrats are in order for Dr. KF, and indeed for the vaping community worldwide.