"Many will be shocked to learn the truth"

A Study, a Controversy, and a Debate Beyond Science

The line between science and media alarmism is becoming increasingly blurred. The dissemination of a study without scientific peer review has reignited the debate on vaping risks and the dangers of misinformation. While the research has yet to be validated by the academic community, its conclusions are already circulating in tabloids worldwide, reinforcing alarmist narratives that could have negative consequences for public health. To what extent does the hasty and irresponsible disclosure of preliminary findings distort the harm reduction debate and perpetuate fear instead of providing scientific clarity?

In the quest for answers about vaping’s health effects, a recent study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria, has sparked a debate beyond scientific data. Is the electronic cigarette a less harmful alternative to tobacco or an as-yet-unknown threat? The question is not new, but how its possible answers are presented reflects a battle of narratives rather than a consensus based on evidence.

The study (see abstract here), led by the Manchester Metropolitan University Institute of Sport under the direction of Dr. Azmy Faisal, evaluated respiratory function and physical performance in three groups of young adults aged 20 to 30: 20 vapers, 20 conventional smokers, and 20 non-smokers/non-vapers. Its findings were quickly seized upon by groups seeking to reinforce their stance in the vaping regulation debate.

Among the first to react was Dr. Filippos Filippidis, chairman of the European Respiratory Society’s Tobacco Control Committee, who emphasized the need to reconsider the perception of vaping in health policies. But beyond the content of the study, the way its conclusions were disseminated raises uncomfortable questions: are we facing a solid finding that challenges the harm reduction consensus, or just another case of rushed science shaped by ideological agendas?

Like others around the world, the Daily Mail tabloid wasted no time amplifying the alarmist tone, quoting an anonymous researcher from the study:

"The risks for someone who continues vaping do not differ from those faced by smokers. At the start of the study, I also believed vaping was less harmful than smoking. Today, many more people vape because they think it is not as harmful. Many will be shocked to learn the truth."

Dr. Azmy Faisal himself reinforced the severity of the findings, noting that “previous research has linked vaping to lung inflammation and harmful changes in blood vessels.” However, he also acknowledged an uncomfortable reality: the long-term effects of vaping remain unclear. Despite this, his team concluded that the risks of electronic cigarettes might not differ significantly from those of traditional tobacco.

But if scientific uncertainty remains a factor, to what extent is it legitimate to present these results as a conclusive truth?

Categorical Findings, Questionable Conclusions

The study reported that vapers showed lower physical performance in exercise tests, performing similarly to smokers. Additionally, both smokers and electronic cigarette users exhibited vascular function impairment, lower oxygenation capacity, and premature lactate accumulation in the blood, along with increased fatigue and breathing difficulties.

Based on this data, the researchers concluded that vaping has adverse effects on respiratory function and physical performance, similar to smoking.

But the study went even further: it suggested a possible link between e-cigarette use and an increased risk of dementia—without providing concrete evidence to support this claim.

This type of speculation without solid evidence is a recurring pattern in the anti-vaping narrative: insinuations disguised as certainties, projected risks without conclusive data, and an emphasis on potential dangers without the same rigor applied to evaluating nuances.

The issue is not about vaping risks but how these warnings are constructed and what level of evidence supports them.

Without Peer Review and with Questionable Media Dissemination

Despite the media impact of its findings, the study has not been published in a peer-reviewed scientific journal. This is no minor detail: without scientific community scrutiny, its results are more of a media statement than verifiable evidence.

Instead of going through traditional scientific filters, the findings were disseminated in sensationalist tabloids, raising doubts about the study’s intent. Is it a legitimate attempt to clarify vaping’s effects or a strategy to reinforce a risk-heavy narrative with no nuance?

Additionally, the sample size is minimal: only 60 participants. Without a more significant and replicable cohort, any conclusion lacks statistical weight and becomes questionable in its generalization.

Despite these limitations, the study aligns with a growing trend: the non-scientific suspicion that vaping risks are more significant than many harm reduction campaigns suggest. The troubling part is that this suspicion is often amplified in institutional forums with a prohibitionist inclination. At the same time, studies presenting nuances or possible benefits of vaping face editorial barriers or are dismissed under accusations of conflicts of interest.

Challenges to the Study: Methodological Criticism and an Incomplete Interpretation

Beyond its media impact, the study has faced intense criticism for methodological flaws that undermine the validity of its conclusions.

1. Lack of Control Over Consumption History
   The study did not verify whether vapers were recent ex-smokers, which could have skewed the results. If a significant portion of vapers had previously smoked, their adverse effects might be due to prior tobacco use rather than vaping itself.

2. Reversal of Lung Damage
   It is well-documented that respiratory damage from smoking can take years to reverse. If vapers were recent ex-smokers, it stands to reason that their lung capacity had not yet recovered. Without controlling for this factor, the study does not prove that vaping is as harmful as smoking—only that ex-smokers take time to heal.

3. Biased Interpretation of Results
   The findings do not prove that vaping is as harmful as smoking but rather that respiratory function recovery is a prolonged process. The real question is whether vaping delays this recovery or allows for a faster improvement compared to continued smoking. The study does not answer this question.

Misinformation and Public Health Consequences: A Risk to Scientific Credibility

A public health specialist, Dr. Michael Siegel, has been particularly critical of how these findings were presented. For him, the study projects a distorted image of vaping’s effects:

"If the vapers in the study were recent ex-smokers, the decline in their lung capacity is not necessarily due to vaping but to accumulated damage from smoking. Without controlling for this factor, we cannot conclude that vaping is as harmful as smoking."

But the problem is not just the methodology—it’s the effect of its unnuanced dissemination. Misinformation about vaping can discourage smokers from considering less harmful alternatives and even push some vapers back to conventional cigarettes—the deadliest option.

The message that “vaping is just as harmful as smoking” is not only scientifically inaccurate, but it could also have negative consequences for harm reduction efforts. Public health policy cannot be based on alarmist headlines but must rely on objective evidence for informed decision-making.

The real question is not whether we should investigate vaping’s risks but whether we are willing to do so rigorously and without ideological biases. Because if fear is the only alternative presented, all we ensure is that many will keep smoking.