Is The Vaping is 95% Safer than Smoking Claim a Myth?

In a bid to drive interest in his talk at the Toronto Public Library, the self-described “internationally recognized forensic toxicologist, author, speaker, scientist” James G. Wigmore has promised to run a series on X exposing vaping myths.

However, if he’s opened with his strongest material, the series is going to be a horror show.

Is the 95% claim fact a myth?

I’m unfamiliar with Wigmore, but his 2023 book, Wigmore on Nicotine and Its Drug Delivery Systems: The Medicolegal Aspects of Our Most Addictive and Dangerous Legal Drug,[1] is available at Barnes & Noble for $125.

The first vaping myth that will be slain on Wigmore’s altar is the oft-cited statement that “vaping is 95% healthier than smoking.” He gets the ball rolling by posting a screenshot of this 2022 article by the Medical Republic.[2]

The article cites Simon Chapman — a well-known anti-smoking activist who has been variously described as a “Sydney pensioner” by Martin Cullip and “the Southern hemisphere’s wrongest man” by Christopher Snowdon — who, according to the author, “tore apart” this vaping claim at an Australian conference.

So, in light of Wigmore’s tacit approval of Chapman’s characterisation of the 95% estimate as a “factoid,” let’s see if the argument that Chapman put up in 2022 can withstand a little scrutiny.

Does Chapman’s dismissal carry weight?

The paper in question was by David Nutt. It was called Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach.[3] For anyone who hasn’t read the paper and doesn’t have the time, I’ll briefly summarise how it worked.

An international panel was set up to evaluate 12 products based on 14 harm criteria. It’s essential to note that the criteria were divided into product harm to users and product harm to others, as you can see below.

Each product was scored by the panel based on harms. The experts drew from their experience in various fields, using a mix of data, research, knowledge, and so on, to come to a consensus about where to place each product on a continuum of risk.

By the end of the process, they arrived at the following:

The authors admit that the report was not purely evidence-based. Indeed, there is a level of subjectivity to weighing and comparing harms.

For Chapman, he suggests that the paper was “based upon fluff.”

So, as far as Wigmore and the Medical Republic are concerned, that’s that. The myth has been busted open like a fat piñata.

But wait?

What is a different independent organisation reached a similar conclusion? Would this kind of replication undermine Chapman’s dismissal?

Well, shortly after the 2014 paper, the 95% claim was backed up by the following:

• A landmark review authored by Professor Ann McNeill and Professor Peter Hajek for Public Health England (PHE) [4] stated that the claim that vapes were “around 95% safer than smoking remains valid as the current best estimate based on the peer-reviewed literature.”
• The Royal College of Physicians independently arrived at the same conclusion in 2016 after a comprehensive review of the available evidence, stating, “the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.” [5]
• Then, in 2018, the PHE further cemented the claim in a report titled E-cigarettes and heated tobacco products: evidence review [6], using a mix of evidence and biomarker data.
• In 2022, an updated meta-analysis of 123 studies titled Nicotine products relative risk assessment: an updated systematic review and meta-analysis [7] bolstered the 2014 paper’s conclusion by suggesting that vapes were 97% safer than cigarettes, as shown in the graphic below.

So, when Chapman dismissed the 2014 report as “fluff” during that conference, there were a few possibilities.

• He is unaware of the studies, research, evidence, biomarker data, and more that strongly argue that vapes are almost two orders of magnitude safer than cigarettes.
• He is aware of the studies but is focused on the 2014 paper because he can blithely handwave it away due to the approach the experts took to forecast relative harms.

Either scenario is a problem for his credibility as an expert.

Ironically, Chapman’s bluster has been lapped up by the likes of The Medical Republic and Wigmore. They both had time to poke holes in Chapman’s claim but came up short.

Let’s hope that Wigmore’s myth-busting series gets a bit better than feebly quoting a man whose hatred of vaping is only matched by his hatred of evidence.