Experts writing in the British Medical Journal have joined The Lancet in criticising Public Health England’s assertion that e-cigarettes are 95% less harmful than tobacco. This is despite PHE’s reference to its research as a “landmark” report, which was also a “comprehensive review of the evidence”.
This latest criticism of the review believes that the research was based on poor quality evidence. Writing in the BMJ, the researchers also highlight the links between some experts, the tobacco industry and firms that manufacture e-cigarettes.
The perceived flimsiness of the evidence in favour of e-cigarettes leads these latest researchers to ask if the claims were “built on rock or sand”.
Professor Martin McKee, from the London School of Hygiene and Tropical Medicine, and Professor Simon Capewell, from the University of Liverpool, said: “A fundamental principle of public health is that policies should be based on evidence of effectiveness.”
The PHE review featured only two randomised controlled trials which led the pair to conclude the evidence was of “low or very low quality”.
Rather than coming from a detailed review of evidence and modelling, PHE’s claims that e-cigarettes are 95% less harmful than smoking “comes from a single meeting of 12 people convened to develop a multi-criteria decision analysis (MCDA) model to synthesis their opinions on the harms associated with different nicotine-containing products; the results of the meeting were summarised in a research paper.”
While the actual research paper itself indicates a lack of “hard of evidence for the harms of most products on most of the criteria […] none of these links or limitations are discussed in the PHE report.”
Prof McKee and Prof Capewell said one sponsor of the meeting was a company called EuroSwiss Health, whose chief executive was reported to have previously received funding from British American Tobacco for an independent study.
As an estimated 2.6 million people in the UK use e-cigarettes, and that they are set to be licensed and regulated as a smoking cessation aid from 2016 , it will be interesting to see what action the Government ultimately takes on the issue.
We recently tackled the issue of e-cigarettes in an in-depth review which you can read here.