Posted at 3:00 p.m.
It was with great dismay that I read an opinion piece, which looked like an advertisement, in The Press last week1. The latter preached the arrival of new solutions to accelerate the decline of smoking in our society. Quickly, the phrase that came to mind was “Homo homini lupus est”, man is a wolf to man; and when it comes to smoking, vaping, or smokeless products, the man gets his teeth in, making the wolf look like a helpless lamb.
As a scientist and researcher in lung health, I live in a world of constant questioning where questioning is perpetual and necessary. I encourage these behaviors among others with my students since in science, the truth is not what we say or what we believe, but what we can clearly demonstrate to the following a rigorous process following the scientific method… which can take years. When you ask a researcher “are you sure?” and you see his gaze leave you for a few seconds, he has long since accepted that certainty is often ephemeral in science; that the more one knows, the more one knows that one knows nothing. So let’s do the exercise of putting on our scientist and researcher glasses for a few minutes and look at the world of smoking, vaping and smokeless products.
By way of example, here is a sentence taken from last week’s text, but which we constantly hear almost everywhere: “… more and more studies, carried out all over the world, show that vaping remains a far preferable alternative to cigarettes. Adjust your glasses properly, let’s go!
The word that strikes a chord, especially for a scientist, is “demonstrate”, suggesting that several studies have followed the scientific method in a clear and rigorous way and have come to the obvious conclusion that vaping has less consequences than smoking. . As a researcher who has been studying vaping for almost five years now, I can tell you that is not the case, but not at all!
Vaping, an alternative to cigarettes?
While it is well established that smoking takes decades to cause cancer and severe lung and heart disease, how do we know what decades of vaping can do when we have been vaping for just over 10 years ? Though rare, but likely underdiagnosed, “vaping-associated lung disease” (VAPD) gives us a taste of it, bringing young and old alike in respiratory distress to hospital and even intensive care.
Why ? How? ‘Or’ What ? We don’t know, but we try to understand, and we know that legal products are a cause, in addition to illegal products.
Moreover, from the point of view of a respiratory health researcher with nice scientific glasses, and knowing that vaping causes VPD, it would be unlikely that a habit like vaping, capable in a few weeks or a few months of affect the lungs of some users to such an extent that hospitalization is required, has no deleterious long-term chronic effects. What would/will be these diseases? Unfortunately, we will have to wait to find out. To be presented with a fait accompli and, again, to try to cure instead of prevent.
Take it from my mouth and write it in stone: “We don’t know if vaping will have greater or lesser effects than smoking on the health of the population in the decades to come”…the best alternative tobacco cigarette health, well, that’s clean air, not the new gizmo from the corner convenience store.
But what can we do? Smoking had reached such a low level among young people. It’s so disappointing to see this beautiful generation addicted to vaping products. Whose fault is it ? To the companies that aggressively sell and advertise these products? To governments beset by lobbyists and slow to legislate? To researchers whose work is not progressing fast enough?
We can play the blame game as much as you want, denouncing the dishonesty of one or the inactions of the other, but the fact remains that it is the knowledge, knowledge and data obtained according to the scientific method that must guide our collective decisions. Support your scientists. Without method and without sound science, we are doomed to cast out witches and blindly follow false prophets. So when you are told with too much certainty about new products or new habits, doubt, question yourself, remain rational, detect conflicts of interest and don’t hesitate to wear your scientific glasses… they have much more style than a cigarette or a vaporizer!
* The author is an associate professor in the Department of Medicine at Université Laval.