So, the internet and the vaping community blew up this week with news of the National Institute of Health (NIH) Addiction Science Award being given to a young woman for her study of “thirdhand” nicotine exposure from electronic cigarettes (NIH, 2014).
I read the report of this study, and while I commend Ms. Lee for her ambitious and timely experiment, I have been compelled to write a response and rebuttal to what I find to be a deplorable attention to validity in hypothesis and methodology. I also have a very hard time believing that her study which beat out two other powerful entries was truly the best design. I fear that the judges were swayed by the amount of attention electronic cigarettes and vaping have garnered in the media and legislation. Did the judges truly believe that the study and results were the best contribution to the fund of knowledge in science, or were they influenced by the legislative and regulatory debates filling the press sheets?
So, let’s talk for a moment about “thirdhand smoke.” In truth, it isn’t truly smoke at all. First hand smoke or nicotine exposure is the smoker or vaper who draws the vehicle of transport (smoke, vapor, transdermal, etc.) into the body where it enters the bloodstream. Second hand exposure is anyone not actively using the device of nicotine delivery inhaling the smoke or vapor expelled by the primary user. Third hand has been defined by Americans for Nonsmokers’ Rights (2014) and Tobacco Control Legal Consortium (2013) as exposure to the deposited nicotine residue from combustible cigarette smoke or electronic cigarette vapor. The smoker or vaper breathes out a cloud of smoke or water vapor in an environment where the particulates and residual chemicals will deposit on surfaces. Any person touching those surfaces at a later time may be exposed to the residual levels of nicotine or toxicants that were suspended in the originally expelled smoke or vapor.
Now, we come to the studies done. First, Ms. Lee was not the first to consider this question. In fact, her study and experimental design were almost identical to a study published by Roswell Park Cancer institute (2014). Ms. Lee used a syringe to draw vapor from three brands of electronic cigarettes and then “exhale” it into a room. A syringe was used to insure consistent puffs. After a period of puffing, the surfaces of window sills and items in the room were swabbed and nicotine levels were measured.
Anyone see the problem yet? The vaping community responded in a roar on various forums pointing out the lack of validity in the study, the overblown “significant increase” description of results, and reminders that the chemicals deposited by combustible cigarettes were vastly worse (E-cigarette Forum, 2014). The problem that I am baffled by is that the judges failed to notice that Ms. Lee did not measure what the title of her study claims to do. That’s right. That is what I said. The study is invalid. It does not measure what it says. The researcher used a syringe to draw the e-cigarette vapor. High school biology teaches us about lungs. If that is the way they worked, the oxygen exchange that delivers that gas to our blood streams would not work, and we would not be inhaling air containing oxygen (among other elements) and exhaling predominantly carbon dioxide. When a vaper or smoker inhales the products of their respective nicotine delivery devices, they are using their lungs to get the nicotine into their bloodstream. In other words, the majority of the nicotine stays in the body of the smoker/vaper. What is exhaled may have some residual nicotine, but nowhere near the amounts that merely pumping the vapor of the electronic nicotine delivery system directly into a room would have.
What Ms. Lee measured in her study was not third hand nicotine exposure. It was first hand nicotine exposure. Incidentally, third hand nicotine exposure is real. Anyone detailing a smoker’s car can prove it by wiping down the dashboard and other surfaces. It is real. However, if you are going to give a prize for a study measuring it, then shouldn’t it be measuring what it claims to measure? Kudos to the young lady for thinking of this and picking a politically hot topic and media worthy. She definitely has achieved the goal of getting attention. I just wish she had remembered enough about biology to produce a valid study.
Contrary to some of the claims of vapers in the forums that nicotine in the residual levels measured are completely harmless (E-cigarette Forum, 2014), I will say that third hand nicotine exposure can still be dangerous to sensitive populations. However, I also believe that vaping produces less residue with lower nicotine levels and fewer dangerous toxicants than combustible tobacco. Others in the scientific community concur, and more people are acknowledging that electronic cigarettes are 60% more successful in smoking cessation efforts than over the counter methods and pharmaceutical smoking cessation products (Kelland, 2014). Bottom line: It appears that there are still a lot of people who are letting hysteria lead the way in the media. Poorly informed and invalid science should not be the basis for regulation decisions or legislation. Regardless of what we don’t know about long term effects, we do know that electronic cigarettes are still safer than combustible tobacco. I would hate for decision makers to be influenced by ignorance and hysteria driven “science.”
Americans for Nonsmokers’ Rights (2014). Third hand smoke. Retrieved from http://www.no-smoke.org/learnmore.php?id=671
E-cigarette Forum. (May 17, 2014). Forum thread responses to Study of third hand nicotine from e-cigarette. Retrieved from http://www.e-cigarette-forum.com/forum/media-general-news/564172-study-third-hand-nicotine-e-cigarette.html
Kelland, K. (May 21, 2014). Study: E-cigarettes very effective at helping at helping smokers quit. Reuters. Retrieved from https://www.yahoo.com/tech/study-e-cigarettes-very-effective-at-helping-smokers-86362892929.html
National Institute of Health. (May 16, 2014). Study of third hand nicotine from e-cigarette exposure wins top NIH addiction science award. Retrieved from http://www.nih.gov/news/health/may2014/nida-16.htm
Roswell Park Cancer Institute. (February 7, 2014). Roswell Park researchers present findings of 2 e-cigarette studies at SRNT meeting. Retrieved from https://www.roswellpark.org/media/news/roswell-park-researchers-present-findings-2-e-cigarette-studies-srnt-meeting
Tobacco Control Legal Consortium. (2013). Thirdhand smoke: A select bibliography of recent studies. Retrieved from http://publichealthlawcenter.org/sites/default/files/resources/tclc-fs-thirdhand-smoke-bibliography-2013_0.pdf