February 16th, 2016

Public health snoopers detect vapour aerosol at vape conference and fake a particulates scare

snooping

In an apparently clandestine operation, undercover public health snoopers ventured into a vape conference carrying concealed air-quality monitoring equipment.  They detected … wait for it … e-liquid aerosol in the air.  This secretive operation is reported (where else?) the journal Tobacco Control.

Let us examine its scientific and policy claims.  

The paper concludes:

Conclusions PM2.5 concentrations observed at the ECIG event were higher than concentrations reported previously in hookah cafés and bars that allow cigarette smoking. This study indicates that indoor ECIG use exposes non-users to secondhand ECIG aerosol. Regulatory bodies should consider establishing policies that prohibit ECIG use anywhere combustible cigarette use is prohibited.

Soule EK, Maloney SF, Spindle TR, et al. Electronic cigarette use and indoor air quality in a natural setting. Tob Control 2016 [link]

Unethical and contemptuous

To start with, I’m pretty disturbed by the approach to vapers betrayed by this exercise – it seems they did these measurements of the particulates in air at a vaping event covertly, and without permission of the event organisers or knowledge of the participants (emphasis added)

The ease of concealment and ability to collect ambient air quality measurements in a natural environment make the Sidepak AM510 an appropriate choice for this type of assessment;

There’s a kind of contemptuous attitude revealed here that takes vapers and their events as subjects for experimentation without their consent rather than people enthusiastically dealing with the health risks of smoking in a way that works for them.

But warped ethics and contemptuous attitude are not the main problems – far from it – and I’m not going to dwell any more on this.

Update 22 February: I have expanded on this section of the discussion in a separate post: What was unethical about snoopers measuring particulates at a vape convention? 

Faking a particulates controversy again – more bad science

The key issue with the detection of ‘particulates’ is what they are made of … these are droplets of e-liquid aerosol. They simply cannot be compared with tobacco smoke particulates, or indeed, the particulates that arise from combustion processes in diesel engines, power stations, biomass or from road surface degradation… These are the types of particulate that underpin the scientific basis for health concerns about PM2.5. E-liquid aerosol is physically and chemically completely different – yet heroic analogy has been used to suggest the concerns should be equivalent. To my knowledge, there is no evidence that particle size per se is a cause of harm… if it was we’d need to take more care boiling kettles and having showers.

I’ve discussed the use of misleading arguments about particulates at some length here: Scientific sleight of hand – constructing concern about particulates and no-one has so far provided any basis for concerns about this sort of particulate. Also, see Carl V Phillips Science Lesson: what are vapor, aerosol, particles, liquids, and such?

This issue is actually discussed in the paper here:

While ECIG aerosol often contains some of the same chemicals found in combustible cigarette or hookah smoke such as nicotine, the composition (ie, concentration of each chemical per puff or product use) of the PM measured in this study likely differs from PM generated from combustible cigarette and hookah smoking. Therefore, this study does not provide the data needed for a direct comparison of the harms associated with exposure to high concentrations of PM generated from ECIG use and hookah or combustible cigarette smoke. 

Likely differs? How about totally differs? But undeterred by this rather fundamental point, the authors try to get back on track by throwing in a bunch of alarming chemical words to make the danger seem clear and present.

While the exact harm potential of secondhand exposure to ECIG aerosol is not currently known, the fact that secondhand ECIG aerosol contains fine particulates, nicotine, carcinogenic aldehydes, polycyclic aromatic hydrocarbons and volatile organic compounds indicates that exposure to secondhand ECIG aerosol may present some degree of harm to bystanders. Importantly, any of these bystanders who are not ECIG users have opted not to inhale ECIG aerosols yet, should they share indoor space with an ECIG user who is using their ECIG actively, are involuntarily inhaling these fine particulates.

But all of this is without any quantification – they didn’t measure the composition of aerosol or compare it to cigarette smoke or hookah emissions. And with toxicology, quantities and exposures are what matters.  You know: “the dose makes the poison” and “risk = hazard x exposure” and all that.

From this statement, you might assume because the ‘exact harm potential … is not currently known’ we are just in the process of narrowing down the science to the last decimal point of risk. But in reality, there is currently no basis for believing there is any material risk to bystanders from e-liquid aerosol.  The exposures to active users are extremely low, and exposure to bystanders would be well below the threshold of concern and far lower than from cigarettes.

Public Health England’s evidence review p64-65 looks at studies in this area and concludes [link]:

EC release negligible levels of nicotine into ambient air with no identified health risks to bystanders.

Nothing in this study overturns that finding. For more on the risks of e-liquid aerosol, see this in-depth review:

For more on the risks of e-liquid aerosol, see this in-depth review:

Conclusion Current state of knowledge about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces. However, the aerosol generated during vaping as a whole (contaminants plus declared ingredients) creates personal exposures that would justify surveillance of health among exposed persons in conjunction with investigation of means to keep any adverse health effects as low as reasonably achievable. Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.

Burstyn I. Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks. BMC Public Health 2014;14:18. [link]

In this study, Igor Burstyn is discussing exposure to active vapers and finds exposures to be below workplace safety thresholds, with no reason for concern about bystander exposure once these aerosols are exhaled and diluted into the ambient air.

Making a policy proposal based on almost nothing

Tobacco Control embarrasses itself again, as it appears no-one involved noticed that this study provides no basis whatsoever to draw the following policy conclusion:

Regulatory bodies should consider establishing policies that prohibit ECIG use anywhere combustible cigarette use is prohibited.

Regular readers will know that I think policy-making is a tough discipline that incorporates science, economics, rights and responsibilities, risk politics, law, options appraisal and impact assessment.  It is truly risible that any research journal allows policy conclusions to be published that are based on such wholly inadequate and partial analysis – in this case a few readings of e-cig aerosol PM. To justify this policy proposal, they would need to consider (at least):

  • why should regulators decide this issue at all? When should regulators intervene and when should it be left to owners and operators of premises like this hotel? The authors don’t say.
  • how can a study that “does not provide the data needed for a direct comparison of the harms associated with exposure to high concentrations of PM generated from ECIG use and hookah or combustible cigarette smoke”  be used as a basis for justifying equivalent policies for smoking and vaping? It can’t.
  • did they translate their findings into an estimate of the risk of harm? No, their methodology doesn’t allow for that, and if they had, they wouldn’t have found a material risk.
  • did they consider the weakness of generalising findings from a vape conference to a single crude rule applied to all settings? No.
  • have they articulated and estimated the costs and benefits of their policy proposal – including welfare costs to vapers, losses to businesses and infringement of property rights? No.
  • have they assessed possible unintended consequences – e.g. vaping bans leading to more smoking or relapse of vapers to smoking? No.
  • have they examined the underlying justification for smoking bans to see if applies here? No. And it doesn’t.
  • have they considered alternative approaches, such as prescription in some places and owner discretion in others? No. They’ve reached straight for the bluntest instrument.

It’s as though the authors think that getting something published in a journal somehow entitles them to insert a ‘policy payload’ to vent their priors and biases as if their article justifies them, no matter what the study finds and whatever limitations it has. If this was a credible journal, it would prohibit policy proposals in conclusions unless they were the main subject of the paper and the policy analysis had been worked through at least as carefully as above.

I am not saying that no-one should care about the impact of vaping on indoor air quality.  Just that based on what we know, the issue is more a matter nuisance and etiquette.  The judgements of owners and managers should determine the vaping policy in any particular setting. Clearly those running a vaping conference may have different preferences to someone running a nursery school. It’s pretty obvious that a vaping conference might make different decisions about vaping policy and the hotel might choose to be vape friendly to encourage this trade.

26 comments to Public health snoopers detect vapour aerosol at vape conference and fake a particulates scare

  • P.S. If you’d like to see an example of the sort of research beneath this tip of the iceberg, check out my satirical take on the whole “outdoor smoking bans” thing at:

    http://wispofsmoke.net/satire.txt

    In the normal world of normal science, a person will read a research study with their main eye focused on the information and knowledge to be gained from the study’s findings. When examining research studies connected with “secondhand smoke” or “involuntary vaping” etc. that main eye focus needs to initially watch for the lies and the signposts of lies (everything from the grant proposals to simply playing with language and terms if, as usual, the data itself is not accessible for checking.) Only after you’ve been able to determine that a paper at least APPEARS to be free from bias should you start to evaluate the actual meaning of its findings into your own base of knowledge.

    – MJM

  • They’ve done this to smokers for years with their little “sniffers.”

    One of their tricks is to emphasize “peak readings” as though the wild number recorded at the moment they sucked in a a passing concentrated whiff was actually the average concentration being breathed by everyone.

    Another standard trick they’ll use is conflating terms: in this case treating water or pg or vg “particulates” as being the same thing as the “particulates” emitted from a coal factory.

    Remember: they’re just Antismokers, and they use EXACTLY the same tricks they’ve always used. Learn their history, study the weaknesses of their past arguments, and see how those same weaknesses appear and can be fought in their present arguments.

    – MJM

  • Never heard of this before, insane

  • […] Public health snoopers detect vapour aerosol […]

  • […] I’ll just link to Dr Farsalinos for the nicotine, glycerine and propylene glycol comment, and Clive Bates for the Particulate Matter. The fact that something (in this case “harmful chemicals” […]

  • […] that study happened, too. The researchers came up with the startling revelation that rooms full of people vaping […]

  • […] Taken straight out of the Glantzian playbook this one. Don’t they realise the make up of the nanoparticles (if they even actually exist) matter? Of course not. […]

  • […] After the hilarious paper in which public health discovered vape conventions and got a little sad they weren’t invited to share their baseless scaremongering, there has been another foray into the world of vaping conventions by researchers. This time, they’re worried that the “particulates” in the air are a massive threat to the health of the people who attend and work at the conferences, but completely brush aside the crucial problem that it’s what the particles are that matters. In this case, they’re droplets of e-liquid; probably posing very little threat to bystanders, if any at all. The various issues with the researchers’ approach and suggestion that vaping should be banned indoors are well-deconstructed by Clive Bates. […]

  • […] recently posted on Public health snoopers detect vapour aerosol at vape conference and fake a particulates scare. I mentioned that I thought it was unethical and contemptuous, but didn’t really explain why. […]

  • […] Public Health Snoopers Detect Vapour Aerosol At Vape Conference And Fake A Particulates Scare &#8211… […]

  • […] was wrong with the content of the paper itself. (You can read more about several of these points from Clive Bates.) There are also some technical concerns about some of the details which I might circle back to, […]

  • […] Clive Bates: Public health snoopers detect vapour aerosol at vape conference and fake particulates scare http://www.clivebates.com/?p=3669 […]

  • Jonathan Foulds

    I suspect that the main point of the article was to demonstrate via measurement that high concentrations of fine particles remain in the air in indoor places where vaping is or has taken place, that the concentration of these fine particles is greater than ordinarily occurs in enclosed spaces, that these fine particles are caused by vaping and that raised concentrations of these particles remain a full day after the vaping. These facts clearly don’t prove harm on their own but they certainly lay the groundwork for further detailed assessment of harms and potential harms, which will presumably depend largely on the chemical profile of the particles in the air and their physiological effects on those exposed.Most people assume that the harms to bystanders will be much less than results from exposure to ETS, but probably greater than zero. This study simply demonstrates these particles are there in the air and so there is a need to study this further.

    • john walker

      Jonathon

      The concentration in the air at a , vaping convention would be much higher than in just about any other conceivable situation.

      Clive
      I would have thought that the researchers -who obviously did not seek the informed consent of their research, subjects- would be in serious breach of just about any University Human Research Ethics Committees guidelines.

  • vapingpoint

    Well, this is exactly how Tobacco Control works isn’t it? They did a really good job with Second Hand Smoke – with STILL no science to back up their twististics. On the back of that, we now have the vicious treatment of smokers in every possible environment – hospitals, prisons, mental health wards, clubs, pubs, the hospitality industry, beaches, parks, in rented homes, old people’s homes, at outdoor venues and god knows what else. It is a world gone insane!

    When dealing with any kind of Tobacco Control, expect smokers and vapers to be dealt with in the same unscrupulous way. Tobacco Control is an evil thing we’d be better off without.

  • Stephen Miller

    Excellent and thoughtful commentary, Clive Bates. Just another example of how ANTZ twist and manipulate the facts to fit their agenda. Tragically, this will cause countless people who are desperate to stop smoking to steer clear of the most effective and less harmful alternative to combustible tobacco use.

    Again, well stated as usual.

  • Jonathan Bagley

    From the paper:

    “PM2.5 was measured because it is a clinically relevant measure: particulates of this size are small enough to be deposited deep inside of the lung if inhaled and take longer to be removed by the body.”

    Apparently an aerosol, by definition, can contain solid particles. My question is whether ecig vapour typically does. If not, the paper is nonsense, as there are no solid particles to be removed by the body.

    My eliquid contains no flavouring – just PG and nicotine, both liquid at room temperature. The aerosol created could only contain particles were they deposited from the heating element. Is this the implication?

    • Clive Bates

      The point is that ‘particulates’ can include liquid droplets, not just solids – of course these behave very differently in the lung tissue to solids or high viscosity liquids.

    • John walker

      From memory there has been atleast one study of the air in a room after several hours of vaping by a number of users, that analysed the chemical content and found next to nothing re toxins. Can’t remember which study.

  • For more details on the whole “particulate matter” nonsense, see my posts at this tag: http://antithrlies.com/tag/particulates/

    • Clive Bates

      Thanks – added a link to the ‘science lesson’. What is truly amazing that this story runs and runs despite the all too obvious weakness of assuming all particulates are harmful.

  • Linda H

    Clive, your previous post was beautiful!

    Regarding the article, I believe you’ve hit the nail on the head with vaping and the fears that the tobacco controllers attempt to create with their junk science.

    My only issue that I have is how cigarettes are used when comparing vaping. While I’ll agree that smoking may have consequences for the smoker, the same tactics used against tobacco are being used against vaping. Namely, fear.

    If we are to balk against the junk science used in the attempts to ban, control or eliminate vaping, we shouldn’t use the claims based on similar junk science that was created to attack tobacco – especially, with regard to second hand smoke. Junk science is junk science and no one should use it to further their agenda.

  • Thank you, Clive, for taking the time to pour over the paper and provide your critical review. Might I suggest you either condense your critique or be prepared to post a number of X of Y posts to the PubMedCommons on this paper? It doesn’t seem to have listed on PubMed yet, but when it does, I encourage you to do so (akin to the back and forth we’ve had on our flavor descriptors paper).

    Joe

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