Eleven top international addiction scientists argue that the 2022 statement on e-cigarettes issued by Australia’s peak health and medical body, the National Health and Medical Research Council (NHMRC), fails to meet the high scientific standard expected of a leading national scientific body.
The NHMRC statement, published in June 2022, aims to provide “public health advice on the safety and impacts of electronic cigarettes (e-cigarettes) based on review of the current evidence.” (1)
This critique of the NHMRC statement, published in the scientific journal Addiction, argues that the statement does not accurately summarise the current evidence on e-cigarettes. In fact, it selectively cites evidence in support of a 2017 statement rather than objectively analysing and incorporating new research. The critique also argues that the NHMRC statement relies heavily on a flawed analysis by the National Centre for Epidemiology and Public Health at the Australian National University.
The authors of the critique cite the following weaknesses of the NHMRC statement:
- It exaggerates the risks of vaping and fails to compare them with smoking.
- It incorrectly claims that adolescent vaping causes subsequent smoking.
- It ignores evidence of the benefits of vaping in helping smokers quit.
- It ignores evidence that vaping is likely already having a positive effect on public health.
- It misapplies the precautionary principle, which requires policy makers to compare the risks of introducing a product with the risks of delaying its introduction.
According to lead author Dr Colin Mendelsohn, “Many leading international scientists in the field hold more supportive views than the NHMRC on the potential of e-cigarettes as a strategy to improve public health. In particular, invoking the precautionary principle to prevent the use of much less harmful smoke-free products is unjustified in the face of the massive public health burden of smoking.”
In sum, argue the authors of this critique, the NHMRC statement confuses association with causation, adopts a double standard by uncritically accepting evidence of harms while being highly sceptical of evidence of benefits, and inappropriately applies the precautionary principle.
1. National Health and Medical Research Council. CEO Statement Summary: Electronic Cigarettes. Canberra: National Health and Medical Research Council; 2022. [accessed 30 Jan 2023]. Available from: https://www.nhmrc.gov.au/health-advice/all-topics/electronic-cigarettes/ceo-statement-summary
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For editors:
This paper is available at the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.16143 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org.
To speak with a co-author:
Dr. Colin Mendelsohn: +61 415976783, mendel@bigpond.net.au
Professor Ron Borland: +61 409979269, rborland@unimelb.edu.au
Emeritus Professor Wayne Hall: +61 421059009, w.hall@uq.edu.au
Full citation for article: Mendelsohn CP, Hall W, Borland R, Wodak A, Beaglehole R, Benowitz NL, Britton J, Bullen C, Etter J-F, McNeill A, and Rigotti NA. A critique of the Australian NHMRC CEO Statement on electronic cigarettes Addiction. 2023. DOI: 10.1111/add.16143
Funding: None
Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.
Journal
Addiction
Method of Research
Commentary/editorial
Subject of Research
People
Article Title
A critique of the Australian NHMRC CEO Statement on electronic cigarettes.
Article Publication Date
20-Feb-2023
COI Statement
Declarations of interests: C.P.M. was an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a registered health promotion charity, from October 2017 to January 2021. ATHRA accepted unconditional seed funding from the vape retail industry to become established. Funding ceased in March 2019. C.P.M. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017. C.P.M. is the author of Stop Smoking Start Vaping, published by Aurora Press. C.P.M. has never received payments from electronic cigarette or tobacco companies. A.W. has been an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a health promotion charity, since October 2017. ATHRA received unconditional funding for establishment costs from small Australian vape businesses. Vape industry funding has not been accepted since March 2019. A.W. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017. A.W. has never received payments from electronic cigarette or tobacco companies. N.L.B. is consultant to pharmaceutical companies that market or are developing smoking cessation medications and is an expert witness in litigation against tobacco companies. C.B. is the lead investigator and recipient of research contracts from the NZ Ministry of Health on tobacco cessation and tobacco control in New Zealand; a co-investigator on grants funded by the NZ Health Research Council; and is a Board member and President-Elect of the Society for Research on Nicotine and Tobacco. C.B. received payment for a consultancy to J&J Japan on nicotine replacement therapy, in 2019. N.A.R. has received no funding (current or past) from e-cigarette or tobacco companies. N.A.R. is a consultant for, and her institution has received research funding from, Achieve Life Sciences for an investigational smoking cessation pharmacotherapy. All other authors have no conflicts of interest to declare.