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WHO can you trust?

WHO "statements are factually uninformative while creating an impression of alarming possibilities," charges a team of scientists responding to recent WHO releases. Background studies (by Grana, Berkowitz, and Glantz) have presented misleading data analysis on a variety of issues, resulting in a WHO document that is likely to create serious misunderstandings among policymakers, claims Anne McNeill of King's College London and the UK Centre for Tobacco and Alcohol Studies, and her colleagues (Etter, Farsalinos, Hajek, le Houezec, and McRobbie).

Use of polemical language and emotional rhetoric, on the issue of e-cigarette marketing, blurs the paramount aim of "encouraging existing smokers to move away from smoking whilst not attracting non-smokers," claim the critics.

On youth use of e-cigs, the WHO and its favorite nicotine scientists (from the University of California/San Francisco) ignore the significance of the persistent decline in youth smoking in the face of a dramatic rise in e-cig use, according to the critique. They consistently imply causality where only cross-sectional data is presented, say McNeill and colleagues, for instance when they not that youth smokers who also vape tend to be heavier smokers, and imply that vaping is leading to smoking, instead of the equally possible reverse. Perhaps most important, charges McNeill, they report one-puff experimenters as e-cig users.

The WHO and its anti-vaping acolytes misrepresent longitudinal studies to make vaping appear ineffective for smoking cessation, says the team of critics. "The same logic that the report authors apply here would reliably associate quit failure with use of any stop-smoking medication or device, however effective," claims the critique.

The McNeill team is highly critical of the WHO team for suggesting that "there is no benefit of cutting down cigarettes alongside e-cigarette use." The "relationship between amount smoked and cardiovascular disease... is non-linear," they agree, but "the statement that cancer risk may be only modestly affected by reduction in toxin intake from cigarettes is highly misleading." There is likely to be benefit from smoking reduction, but the amount is unclear, and perhaps less than one might wish.

By far the most important flaw the critics discover is a consistent " failure to report the magnitude of the difference in concentrations of potential toxins between cigarette smoke and e-cigarette vapour."

Says co-author Peter Hajek of the Tobacco Dependence Research Unit at Queen Mary University of London, “There are currently two products competing for smokers’ custom. One, the conventional cigarette, endangers users and bystanders and recruits new customers from among non-smoking children who try it.  The other, e-cigarette, is orders of magnitude safer, poses no risk to bystanders, and generates negligible rates of regular use among non-smoking children who try it. The WHO recommendations blur these differences and if followed, will cripple the competitiveness of e-cigarettes and help to maintain the market monopoly of conventional cigarettes.”