Prominent anti-tobacco activist risks skewing science and public opinion against e-cigarettes

There can be little doubt that Stanton Glantz is one of the foremost opponents of Big Tobacco. Over a career spanning more than five decades and almost 400 scientific papers, Glantz has often been lauded for his efforts in exposing industry secrets, highlighting the harms that smoking does to public health and spearheading campaigns to better regulate the sale of tobacco products.

But while Glantz’s anti-smoking crusade is commendable, the same cannot be said for his peculiarly aggressive attitude towards vaping, outlined in detail in a recent profile of the anti-tobacco activist. The serious doubts which hang over the scientific rigor of his claims about e-cigarettes have not only cast a pall over his own legacy, but his intransigent stance on the topic may also trigger much farther-reaching ramifications if it encourages national and international authorities to take misguided measures against reduced risk products like e-cigarettes.

There is a marked difference in the risks posed by e-cigarettes and combustible tobacco, with vaping estimated to be roughly 95% safer than smoking. Given the substantial evidence suggesting that switching to vaping could save the lives of millions of smokers, regulations that fail to distinguish between smoking and vaping are counterproductive from a public health perspective and could lead to higher smoking rates. Indeed, Glantz’s short-sighted condemnation of e-cigarettes may perpetuate the very industry he has spent his life trying to dismantle.

Politics over science

For decades, Glantz was a veritable thorn in the side of Big Tobacco, including as a key figure in the collation of more than 14 million incriminating documents which comprise the online tobacco archive. It was this valuable work which helped expose the deceit of tobacco industry executives when they claimed in 1994 that they were not aware that their products were addictive. The ensuing court case was a major landmark victory in the fight against Big Tobacco.

However, Glantz’s methods were at times controversial. As far back as March 2003, Glantz threw his weight behind a study from Helena, Montana, which produced the jaw-dropping suggestion that a six-month public smoking ban had precipitated a 60% drop-off in heart attacks. The paper received widespread press coverage – despite the fact that the sample size (just seven cases prior to the ban and four after) was so small as to make the results virtually meaningless, especially when other, larger research projects from the UK and New Zealand seemed to contradict them. This kind of fudging of the facts to fit the narrative was overlooked by many anti-tobacco campaigners, because they believed the cause to be a noble one.

Now, however, Glantz is employing the same tactics against e-cigarettes and the rank and file are not as silent. For example, in attempting to link e-cigarettes and heart attacks, Glantz conveniently ignored the fact that many of the heart attacks in one group of study subjects took place prior to the patients ever touching an e-cigarette—a remarkable 10 years before in one case. After a backlash from the scientific community, that paper was subsequently retracted by the American Heart Association – a highly rare occurrence. In another striking example, Glantz was publicly called out by a King’s College London scientist whose work he referenced in a meta-analysis on e-cigarettes, claiming it was “either inaccurate or misleading” – and that Glantz ignored her privately-expressed concerns prior to publication.

Warped opinion imperils public health

This tendency to play fast and loose with the available scientific evidence is particularly troubling with regards to vaping, since it risks muddying the waters around a practice which could help countless smokers reduce the harm to their health.

Any conflation of vaping and smoking, as if they carried equivalent risks, is particularly damaging for public health. The comparison isn’t just a faulty one – Public Health England maintains that vaping is 95% less harmful than smoking – it’s a risky one, too. Surveys show that 59% of Europeans mistakenly believe e-cigarettes are at least as dangerous as tobacco, an incorrect risk assessment which undoubtedly contributes to the continent’s stubbornly high smoking rates.

Those erroneous opinions appear to pervade through to positions of power, as well, with the World Health Organization’s latest tobacco progress report calling for tighter regulations on vaping. The report has already sparked plenty of criticism, with public health experts claiming that it fails to differentiate between “addiction to tobacco smoking, which kills millions of people every year, and addiction to nicotine, which doesn’t” and that clamping down on e-cigarettes would only encourage greater consumption of combustible tobacco.

Regulations must be tailored to risks

Nonetheless, some governments and municipal bodies have already made troubling moves in this direction. In the EU, Hungary has already banned the sale of flavoured e-cigarettes; a Danish ban on their sale will enter into force in April 2022 and the Netherlands are considering following suit – a decision which could see over a quarter of a million smokers return to combustible tobacco. Policymakers have tried to justify the moves by suggesting that non-tobacco vape flavours could entice young people to take up smoking. However, a study from the Yale School of Public Health (YSPH) found that San Franciscan schoolchildren were twice as likely to use combustible tobacco after a similar ban was implemented in their city, suggesting the opposite is actually the case.

By tarring e-cigarettes with the same brush as combustible tobacco and supporting regulations which conflate the two, Glantz, the WHO and governments across the globe could actually be exacerbating the very tobacco epidemic they aim to eliminate.

This article does not necessarily reflect the opinions of the editors or the management of EconoTimes