Dr. Konstantinos Farsalinos has built a respected reputation over the last several years by replicating and rebuking poorly designed vaping studies. In his over ten years of research on e-cigarettes, Dr. Farsalinos has never been afraid to call out misleading analysis, generally by pointing out exactly how they’re, intentionally or not, disseminating false or incomplete information. He’s conducted over 50 studies that aim to understand the differences between vaping and smoking both short and long-term. He is also one of the most influential voices in the European vaping debate.
The latest report in his sights is the well-circulated study from last week that found toxic metals in e-liquid vapor. The research was published in the Environmental Health Perspectives Journal under the title, Metal Concentrations in E-Cigarette Liquid and Aerosol Samples: The Contribution of Metallic Coils. According to the researchers, after testing vaporizers used by 56 everyday vapers, they claimed to find potentially unsafe levels of several substances, especially metals. But after carefully analyzing the report, Dr. Farsalinos concluded that the researchers had taken several critical points out of context, skewing the final results as well as their implications.
The researchers in question, who work for the John Hopkins School of Public Health, got 56 vapers to bring their personal vaporizer with them for testing. After doing extensive tests on the e-liquids and aerosol, both before and after use, they concluded that toxic metals such as arsenic, chromium, manganese, nickel, and lead were present after vaping. They even claimed that the most significant metal concentrations were observed in devices that had their coils changed more often. According to the researchers, this constitutes a serious concern, as excessive levels of these substances have been linked to many types of cancer, immune conditions and cardiovascular issues. The only problem is, these concentrations are far too low to be a cause for concern, according to Dr. Farsalinos.
The primary point made by Dr. Farsalinos in his rebuttal of this study is simply that the researchers failed to explain the context of these toxic substances, therefore making the results unnecessarily bombastic. He took to his Facebook page to answer the concerns of many vapers who asked him about the legitimacy of the toxic metals study. “The ‘significant amount’ of metals the authors reported they found were measured in ug/kg. In fact, they are so low that for some cases (chromium and lead) I calculated that you need to vape more than 100 ml per day in order to exceed the FDA limits for daily intake from inhalation medications.” He suggested that this happens because studies sometimes use concentration limits associated with constant intake, as opposed to just the breaths that include e-liquid vapor. According to Farsalinos, “humans take more than 17,000 breaths per day but only 400-600 puffs per day from an e-cigarette.” So when researchers calculations omit this fact, the results can appear drastically worse than they ought too.
Taking Results Out Of Context
This isn’t the first time that the renowned tobacco harm expert had to debunk potentially serious vaping studies. He’s cautioned researchers to be wary of errors and misleading contexts. In his view, many researchers have in the past omitted errors and findings that don’t match up with what they were trying to prove. He implores researchers to fully understand the relevant contexts and implications before publishing results like these. Especially in cases where they’re not intentionally skewing their findings, it’s vital researchers avoid publishing misleading results that endorse poor public trust in e-cigarettes.
This isn’t the first time Dr. Farsalinos had to point out obvious flaws in anti-vaping research to prove they’re missing the full picture. Back in November of last year, Dr. Farsalinos conducted a few replication studies hoping to understand how the original researchers reached their conclusions. One of these studies aimed at a famous 2015 study published in the New England Journal of Medicine that claimed vaping could be around 15 times more carcinogenic than traditional cigarettes.
To replicate the originally reported findings, Dr. Farsalinos obtained the same equipment used by the researchers and tested the levels of formaldehyde present while following the same parameters of the NEJM study. What he found was that, in spite of using an atomizer far less advanced than what is commonly available today, they needed to far exceed reasonable conditions even to approach the formaldehyde levels reported. In fact, the conditions required to match the original findings can reasonably be considered unrealistic, as dry-puffs would become unavoidable well before such a high voltage.
Studies like the recently published toxic metals report are extremely detrimental to vaping. It’s well known that the public perception of e-cigarettes is overall negative. One poll by the UK’s Action on Smoking and Health found that only 13% of adults believe that vaping is safer than smoking, while over 25% think vaping is just as, if not more dangerous. With that being the case, it makes vaping an even easier target for media outlets looking for an attention-grabbing headline.
This time is no exception, with headlines decrying vaping circulating widely last week. If it weren’t for people like Dr. Farsalinos, it would be much harder to fight these false narratives. Yet these horrendous public perception numbers persist in spite of the mountains of peer-reviewed evidence indicating vaping is at least 95% safer than smoking. The only way to change the tide is to prove that many of the anti-vaping studies published are peddling half-truths or omit essential pieces of the context. That is why we must support replication studies like those done by Dr. Farsalinos, as successful replication is the only way to be sure that something is legitimate.
What do you think about the toxic metals study? Do you believe that Dr. Farsalinos is doing valuable work? How else can we work toward greater acceptance of vaping in the general public? Let us know in the comments.