transcript

Speaker 1:
[00:00] Hi, I'm Wendy Zukerman. This is Science Vs. The show that pits facts against fumes.

Speaker 2:
[00:13] Groundbreaking new research has confirmed a deadly link between e-cigarettes and cancer.

Speaker 3:
[00:18] Vaping is likely to cause lung and oral cancer.

Speaker 1:
[00:22] Headlines have been screaming about a new paper that's rocking the vaping world, claiming that vaping is more dangerous than we thought. We're hearing that not only is it likely to cause cancer, but also that something that scientists have been telling us for years is wrong.

Speaker 4:
[00:41] So is it safer to vape than smoke?

Speaker 2:
[00:43] Well, now the science is in.

Speaker 4:
[00:45] New research has found vapes are no safer than conventional cigarettes.

Speaker 5:
[00:50] The conclusion is unavoidable. We can hardly say that e-cigarettes are somehow safer than conventional cigarettes.

Speaker 1:
[00:58] Vaping is as bad as cigarette smoking? Now, if this is true, it is a huge switcheroo for science, and also for Science Vs. For literally a decade, we've been telling you that vaping is a safer and better alternative to smoking. In a past episode, we even played you a song, written by a bunch of researchers about it. So did we lie to you? Through song? Will we fall on our own batard? I mean, will we be hoisted on our own batard? Well, the thing is, while some nerds have been supportive of this new paper that's sparking all these headlines, others are not. And in fact, right after the paper was published, a bunch of scientists wrote angry responses, calling the paper misleading, problematic, and saying it has little credibility. So what's going on here? And getting this right is a big deal. Millions of folks, including kids, have picked up vaping around the world. So today on the show, we are asking, one, does vaping cause cancer? Two, is vaping as bad as smoking now? And three, could picking up a vape ever be good for your health? When it comes to vaping, there's a lot of... No, no more songs until we work out what the devil's going on here. And it's all coming up just after the break.

Speaker 3:
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Speaker 1:
[03:17] This episode is brought to you by Amazon Health AI. Guys, we gotta talk about your secret late night internet searches. You know the ones. Bumpy leg rash, hair loss, itchy bum. Trying to figure out your body by endlessly searching for answers.

Speaker 6:
[03:31] We all do it, but does it always work?

Speaker 1:
[03:34] Well, you could try Amazon Health AI. It can connect your symptoms with your medical history to offer personalized care 24-7. So, call off the search. Amazon Health AI is here. Healthcare just got less painful. Hi, Wendy here. Today, we are finding out, is vaping more dangerous than we thought? And with me to sort all of this out is Senior Producer Rose Rimler.

Speaker 7:
[04:04] Hi, Wendy.

Speaker 1:
[04:04] Hello, Rose.

Speaker 7:
[04:05] I don't think I've ever heard that song before in my life. Do we play that?

Speaker 6:
[04:13] We played it.

Speaker 7:
[04:16] So memorable, seemingly.

Speaker 6:
[04:17] I've had it in my head all week. In the middle of the night, this acoustic guitar would just start ringing.

Speaker 1:
[04:25] All right, let's jump into this new study that's setting the vaping world alight, igniting all these news reports. It is quite interesting and the implications are super, super important. So I want to work out what's going on. What's this science fight all about?

Speaker 7:
[04:42] Yeah.

Speaker 1:
[04:42] So to get to the bottom of this, Rose, you and I, we read this paper and then I called out one of the lead authors, Professor Bernard Stewart. He's at the University of New South Wales in Sydney.

Speaker 5:
[04:53] Good morning.

Speaker 7:
[04:54] Morning.

Speaker 1:
[04:55] Now Bernard told me that basically his entire career has been using research to figure out whether various things in our environment cause cancer. So a decade ago, he was part of this big international team that looked at the characteristics that a substance has to have for it to be considered carcinogenic. He's looked at PFAS, forever chemicals.

Speaker 5:
[05:18] Microplastics, pesticides in soil.

Speaker 1:
[05:22] But when he was watching the data coming out on vapes or e-cigarettes, he told me.

Speaker 5:
[05:28] This to me was a far greater worry.

Speaker 7:
[05:31] Out of curiosity, did he ever find evidence that something didn't cause cancer?

Speaker 1:
[05:36] Yes. Yes, he did. And he actually, he specifically told me, you know, we have this idea that everything causes cancer.

Speaker 4:
[05:44] But he said, that's not true.

Speaker 7:
[05:45] Okay, that's good.

Speaker 1:
[05:46] And in that context, he was worried about vaping causing cancer. So he and his colleagues pulled together studies published from 2017 to the middle of last year that were looking for a link between vaping and cancer. And they wrote it up in a review paper. And so now I kind of want to go through the case that Bernard is making that vaping causes cancer. So we know that some of the chemicals found in vape aerosols, I'm thinking acrylamide, benzene, and various metals, they can cause cancer in humans. But there was this question of when you use a vape and inhale that stuff, do you just breathe it out again? Or does it go into your system where it can then cause damage? And so scientists have tested the blood and urine of vapors for these kinds of chemicals, and here's what they've found.

Speaker 5:
[06:42] Those chemicals are detectable. In other words, they have been absorbed into the body and not just exhale.

Speaker 1:
[06:52] So strike one. There are also studies in cells where scientists expose them to vape liquid and then they can see that these cells pick up DNA damage and oxidative stress, which we know can lead to cancer. Yeah. On top of that, scientists have exposed rats and mice to the vapor from e-cigarettes, and they can see markers of inflammation in their lungs. And this is worrying to Bernard because we know that inflammation, when it's chronic in other circumstances, can lead to cancer. One study in particular exposed mice to vape fumes for almost a year, which is a long time in the life of a mouse, and a bunch of them developed lung cancer. So then finally, Bernard's team point to a few case reports. So here he is on that.

Speaker 5:
[07:41] Individual dentists say, I saw a patient with oral cancer and this patient never smoked, which is the well-known cause of oral cancer. But he or she did vape and I suspect the vaping was connected with the cancer.

Speaker 1:
[08:00] Now it's messy because in the four case reports that Bernard cites, two of those people did have a history of smoking as well.

Speaker 7:
[08:10] Real regular cigarettes. Yes. I noticed that.

Speaker 1:
[08:13] Still, but when Bernard looks at the totality of the evidence, here's what he thinks.

Speaker 5:
[08:19] All of that data, the laboratory data, the biomarker data, the animal data, the case reports, all of that taken together, lead us inextricably to the conclusion that vaping is likely to cause oral and lung cancer.

Speaker 1:
[08:39] In the case of vaping versus cancer, that is the case that Bernard is making. But Rose, you were going to play defense on this, right?

Speaker 7:
[08:50] Yes. There were a lot of scientists who were pissed off by this paper.

Speaker 1:
[08:54] Yeah.

Speaker 7:
[08:56] I wanted to find out why. We called up one of them, Professor Leon Shahab. He is a vaping expert at University College London. Leon didn't think the review was put together in a systematic way. He didn't like that. Yeah. But he said that's not the only reason that he's skeptical.

Speaker 8:
[09:14] The concern is further deepened by the fact that this review includes several papers that claim evidence that e-cigarettes cause cancer, but that have themselves been heavily criticized.

Speaker 1:
[09:25] Tell me more.

Speaker 7:
[09:26] Well, so you mentioned the rodent studies, like the one where some of the mice that got exposed to vape aerosol got lung cancer.

Speaker 1:
[09:36] Yes.

Speaker 7:
[09:36] In that study, the mice were living in a chamber that got filled up with the vape fumes. Basically, they were being hotboxed with vape.

Speaker 1:
[09:47] Yes.

Speaker 7:
[09:47] That's how they do these, right? They got hotboxed for four hours a day, five days a week.

Speaker 8:
[09:54] They were basically enveloped in a cloud of vapor. It doesn't seem like a realistic use condition for a human.

Speaker 6:
[10:00] Isn't it?

Speaker 1:
[10:01] I mean, obviously, you're not living in a cloud if you vape, but you are breathing it in directly from the vape, right?

Speaker 7:
[10:10] Sure, but you're not sitting in a chamber of vape clouds for hours and hours.

Speaker 6:
[10:15] Unless you truly are a vape lord.

Speaker 7:
[10:19] I mean, most people, I know, don't do that. I've never seen vapers lick the vape off their body, which is what mice might be doing because rodents groom themselves.

Speaker 1:
[10:30] Oh, right. So they'd be licking their fur that then has the vape crap on their fur.

Speaker 7:
[10:36] Which would have gotten some extra exposure, a different route of exposure. That's just a criticism you can make about these studies. I emailed the author of the paper, that paper about the mice, some questions. Yeah. He said, we tried carefully to create conditions that are as natural as possible to what vapors might get exposed to. But even he was like, yeah, ultimately, it's a study in mice. He said, this is a quote, the major purpose of exposing mice in an inhalation chamber is to determine the effect of e-cigarette aerosols in mice. So of course, we can't say the same is going to be true for humans.

Speaker 1:
[11:13] Of course. It's step one. It's step one. Yeah.

Speaker 7:
[11:16] So the other point that Leon made, and this has to do with, I think the first thing you mentioned, Wendy, about how it turns out the toxic chemicals, the carcinogens, they actually get in the bodies of the vapors. You can find them in their pee. And that is certainly not a good thing. Leon and other experts who commented on this paper, they pointed out that like, well, these amounts of carcinogens that we find in vapors bodies, they're actually kind of low. And as Leon puts it, the dose makes the poison, right? And that's just sort of a general rule in epidemiology that the more you're exposed to something that has some kind of risk, the more likely you are to develop that disease, you know? And so with vaping...

Speaker 8:
[12:03] It's unclear whether this lower level of exposure that's quite small represents an actual risk for cancer formation.

Speaker 7:
[12:10] Now, I mean, Leon did say, he agrees, it's totally possible vaping could have a risk of causing cancer. He just doesn't think that we currently have the evidence to support saying that, for sure, yes, we know now vaping does cause cancer. And one reason is, we actually don't have much data in actual human beings with actual cancer. And I really went looking for other evidence that didn't make it in Bernard's review of people who vape getting cancer. And I did find some studies, and they find things like people who vape are more likely to have lung cancer, for example. But in all the studies that I could find, a lot of the vapors also smokes or used to smoke. Right. So we don't know if the cancer came from the vaping or the smoking. It's messy. And that makes it a real mess. Yeah. And so without more evidence in people actually getting cancer, I don't think that these authors should have said that they have produced the, this is what they said in a press release, they call it, the most definitive determination that those who vape are at increased risk of cancer compared to those who don't. I think that is an overstatement.

Speaker 1:
[13:23] Yeah. I mean, I did ask Bernard about some of the heat that this paper's been getting. No pun intended. You must be aware there's some criticisms of the paper that have been floating around.

Speaker 4:
[13:35] Do you mind if I just get your thoughts on them?

Speaker 5:
[13:37] Yes. The criticisms are absurd and I treat them with complete contempt. Whoa.

Speaker 7:
[13:46] That's a strong word. Is he mad at me?

Speaker 5:
[13:48] Oh, no.

Speaker 1:
[13:49] I mean, I think he was bristling at some of the criticisms he's been getting about how there's nothing new in this paper. It's a review. But ultimately, he said, if you've got problems, write a letter to the editor.

Speaker 7:
[14:03] Does making a podcast count?

Speaker 1:
[14:06] I think he would treat that with contempt.

Speaker 6:
[14:10] No, but seriously, he did.

Speaker 1:
[14:12] He told me, of course he knows that this is not rock-solid evidence. We don't have a study in thousands of people where you see that those who vape have higher rates of cancer than those who don't vape. Like you mentioned, Rose, part of that is because of this messiness that a lot of vapers, and particularly older vapers, are smokers too, or they used to be smokers. But the other issue here is also time. Bernard estimates we'd need around three decades before you might see that cancer signature because cancer takes a really long time to develop, even for cigarette smokers. And vaping was only invented in the 2000s. That's actually why they call it the Noughties.

Speaker 7:
[14:57] That's not true, kids. Don't let Wendy do revisionist history. That's true.

Speaker 1:
[15:01] No. Okay. So I asked Bernard, and why not wait for better evidence before making this claim?

Speaker 5:
[15:09] You're serious? You're saying we wait around until enough people are dead from lung cancer before we do anything? Is that what you're suggesting?

Speaker 6:
[15:19] Well, I want you to explain so that we could take to our audience.

Speaker 5:
[15:25] The definitive proof will take decades, okay? It took just on a 100 years to definitively prove that cigarettes cause cancer. Cigarettes by that time have become the major known cause of cancer in the world.

Speaker 7:
[15:47] I mean, I see his point though, like it's like the precautionary principle, right? You know, better to be safe than sorry. At the same time, it doesn't really give people license to get out over their skis and say that we have proof that we don't have. It's bad for science more broadly.

Speaker 1:
[16:06] I mean, the truth is, a lot of the team, the whole team at Science Vs. struggles with this, and so what we did, we know our limitations. We're podcasters, we don't write letters to editors. So we surveyed a bunch of researchers who study vaping and tobacco control to see what they make of all this. We asked them outright, does vaping cause cancer? We heard back from 35 scientists, and the results were kind of all over the map, but I would say the majority said, we don't know, but it's possible. And some who were then in that, maybe we don't know, Cam, said, all right, if vaping does cause cancer, then the question becomes how much does it up your risk of cancer? Is it like breathing an asbestos or eating a salami every now and then?

Speaker 7:
[16:58] Yeah.

Speaker 1:
[16:59] And we definitely don't know that.

Speaker 7:
[17:02] You know, if there was no potential benefit to vaping, it would be very easy to close the book on this to say like, okay, this is enough evidence to just assume it does and tell people, quit it, don't vape. And be like, of course, if there's evidence that this thing, you know, playing the kazoo is potentially carcinogenic. And we have animal studies, we have petri dish studies, we have kazoo players have higher levels of this chemical that causes cancer. That, everyone stop playing the kazoo. I think that would be, even though we don't have studies saying kazoo players get tons of cancer and die.

Speaker 1:
[17:41] It's an irritating sound as well. So that would be great.

Speaker 7:
[17:45] And it irritates people around you with its second hand kazooing.

Speaker 1:
[17:49] Yes.

Speaker 7:
[17:50] But this is totally ignoring the fact that there is a potential benefit of vaping. And that's for people who smoke. And so if you're evaluating vaping as its own thing, ignoring the fact that its major purpose is as a smoking cessation device to get people to stop smoking when it's very hard to do that, you're missing like a huge part of the argument here.

Speaker 1:
[18:14] So Rose, we are going to look at that huge part of the argument and see if it's about to all go up in a puff of smoke after the break. Coming up.

Speaker 9:
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Speaker 7:
[21:14] I am your host, Stacey Schroeder. Welcome to Tell Me Lies, the official podcast.

Speaker 12:
[21:19] What's the most unhinged thing of season three? Steven, because he's so evil.

Speaker 4:
[21:24] I do think he is misunderstood.

Speaker 9:
[21:26] You see everyone face consequences.

Speaker 12:
[21:28] It's intoxicating.

Speaker 7:
[21:29] The writers just know how to trick you.

Speaker 3:
[21:32] There's always a twist in this show, so nothing you would expect.

Speaker 7:
[21:35] Tell Me Lies, the official podcast, now streaming and stream the new season of Tell Me Lies, and Hulu, and Hulu on Disney Plus.

Speaker 1:
[21:47] Welcome back. Today on the show, we are looking at the new science on vaping. Rose Rimler is here with me.

Speaker 7:
[21:56] Hi, Wendy.

Speaker 1:
[21:57] Now, we're going to look at this claim that vaping is just as dangerous as smoking. And as I mentioned at the start of the show, if true, this would really be a huge turnaround for science, which absolutely happens. We get more data, we find out new things, we change our mind. That is the glory and the frustration of science.

Speaker 7:
[22:17] Right. Yeah.

Speaker 1:
[22:18] It's why we love it. She's a feisty beast. So there were all these news reports recently, particularly in Australia, saying that vaping is not safer than cigarettes. Off the back of Bernard's paper. But what's interesting is Bernard's paper was really not comparing vapes to cigarettes. In fact, the whole point of the paper was to say that vaping in its own right is harmful, forget about comparing it to cigarettes.

Speaker 6:
[22:50] And yet, did you notice this in the very last, it's just in the very last line of the paper, it's almost kind of tossed out.

Speaker 1:
[22:59] They say, quote, cancer aside, a range of diseases are attributable to vaping, which can no longer be caricatured as safer than smoking.

Speaker 7:
[23:09] Wild claim. That's where scientists put their wild claims, is in the last line of their last paragraph.

Speaker 6:
[23:16] You're right.

Speaker 1:
[23:17] It almost, I don't know if you had this feeling, but it was almost as if for the whole paper, the scientists are breaking up with vaping, and then they turn around and walk away, but then toss off, oh, and you're bad in bed too.

Speaker 6:
[23:31] And you're just as bad as smoking. Do you know what I mean?

Speaker 7:
[23:35] Yeah. It is like, I noticed that too. I was like, whoa.

Speaker 1:
[23:39] Yeah. And the reason that it is so, whoa, so shocking is because of just how bad cigarette smoking is. So to remind us, here's Professor Becky Freeman. She's a public health researcher who focuses on tobacco control and vaping at the University of Sydney.

Speaker 12:
[23:57] Two out of three people who continue to smoke. So if you're not able to quit, two out of three people who are unable to quit will die as a result of their addiction. There's just something, it's so uniquely harmful to health. They're so deadly.

Speaker 6:
[24:11] So could vaping really be that bad?

Speaker 1:
[24:16] Given that we've just talked about these unknowns around vaping and cancer, what do we actually know here? I mean, could vaping be as dangerous as smoking?

Speaker 7:
[24:26] So I looked into that claim, and what's interesting is that there are other scientists who say, we should rethink this idea that vaping is flat out better for you compared to smoking.

Speaker 6:
[24:36] Really?

Speaker 1:
[24:37] So where are those researches coming from?

Speaker 7:
[24:39] Well, I mean, in Bernard's paper, one of the things he cites to make this case that vaping is really bad is a review paper that came out a couple years ago. And this one was looking mostly at heart and lung problems in people who smoke or vape. So for that, we do actually have studies in real people. And this review paper concluded that smoking and vaping are equally bad for cardiovascular disease, stroke, and metabolic dysfunction.

Speaker 1:
[25:10] Wow.

Speaker 7:
[25:11] That stuff that can lead to like diabetes and stuff. Wow. And that's a pretty big deal. And so from Bernard's perspective, if he's pretty sure that vaping is on its own cancer causing, and this other body of research says vaping on its own is heart disease causing, boom, like death to vaping.

Speaker 1:
[25:30] Why is vaping so bad for your heart?

Speaker 7:
[25:33] One reason is that nicotine itself is a vasoconstrictor, so it could like tighten your blood vessels, and you can imagine how that would be bad for your cardiovascular system.

Speaker 1:
[25:41] Yeah. And vapes have a surprisingly high amount of nicotine in them.

Speaker 7:
[25:45] Yes. And getting higher all the time. Like there are studies that have found that the cartridges in vapes are bigger and contain higher percentage of nicotine than they used to.

Speaker 1:
[25:59] Yeah, wow. Okay.

Speaker 7:
[26:01] Yeah.

Speaker 1:
[26:02] That's helpful for the bottom line, isn't it?

Speaker 7:
[26:04] Yeah. And so like Wendy, I have to tell you that this review paper I just mentioned did also get a lot of criticism.

Speaker 9:
[26:11] Right.

Speaker 7:
[26:12] All kinds of things people said about like, oh, they didn't account for the fact that people might have been former smokers and switched to vaping because they got sick and they needed to switch.

Speaker 9:
[26:24] Right.

Speaker 7:
[26:25] But authors do argue back like, hey, we tried to adjust for a lot of these things and da-da-da-da, we think we've seen something real here.

Speaker 1:
[26:31] So we're kind of stuck in this scientific limbo land.

Speaker 7:
[26:34] Yes. So vaping is clearly bad for your heart. Whether it's as bad as cigarettes, I mean, I think that's a little bit remains to be seen. But where the case that smoking is still the worst option, is very strong, is when it comes to cancer.

Speaker 1:
[26:53] Yeah. I mean, of course, because we know smoking causes cancer, and we're not even sure about that with vaping, right?

Speaker 7:
[27:00] But yeah, but that's not even exactly what I'm talking about here. Also, when you look at the amount of carcinogens that people are exposed to when they vape versus when they smoke, it's just so much higher in smokers.

Speaker 1:
[27:11] Mm, right. All of these DNA-damaging chemicals, so much higher in smokers.

Speaker 7:
[27:17] So for example, there's this chemical, it's called, a group of chemicals, they're called tobacco-specific nitrosamines, and they're well-known to cause cancer. They're present in the P of vapors at five times the levels. They're in the P of non-vapors.

Speaker 1:
[27:31] Five times higher in vapors.

Speaker 7:
[27:33] But when you look at smokers, these tobacco-specific nitrosamines, they're in the smokers' P 220 times as much as, you know, your goody-two-shoe that doesn't smoke or vape.

Speaker 1:
[27:47] It's way higher.

Speaker 7:
[27:48] Way higher.

Speaker 1:
[27:49] Yes. And when we go back to our survey of scientists, remember those cautious fence-sitting nerds? Well on this question of, is vaping more dangerous than smoking, they were much more clear-eyed. 90% said smoking is more dangerous than vaping. And the rest said, probably, one person said, it's hard to say. So, you know, 90% that is like, dentists recommended Colgate.

Speaker 7:
[28:23] Rock solid.

Speaker 1:
[28:24] I think we can say vaping is still safer than smoking, and we did not lie to our audience in song.

Speaker 7:
[28:30] Great. We can sleep at night now. I'm so glad.

Speaker 1:
[28:33] Oh gosh, I know. So I think the broad message around vaping, when compared to smoking hasn't changed that much. I mean, when Science Vs. did our first episode on vaping, one of the key side to say interviewed said, quote, because the danger of cigarettes is so stratospherically high, it's like comparing the 15th highest mountain in the world, that would be vaping, to Mount Everest. And the joke I made back then, which I still think is pretty good, is that climbing Mount Gai-a-chung-kang is still pretty tricky.

Speaker 7:
[29:06] Is that the 15th tallest mountain in the world?

Speaker 6:
[29:09] Yeah.

Speaker 7:
[29:12] Well, no one said they didn't learn anything from this episode, because they did.

Speaker 6:
[29:16] That's right. Okay.

Speaker 1:
[29:19] But seriously though, this has made me wonder, why are we comparing vaping to smoking? Why are we doing this mountain comparison? Because even if we get more data that vaping is bad, and it becomes, I don't know, Gashabrum 2, the 13th highest mountain in the world, what if it even gets so bad that it's Gashabrum 1, which is the 11th highest mountain in the world? I mean, the broader point is that currently, at least, when we compare vaping to smoking, vaping looks good. Still, despite these headlines you hear, vaping looks good.

Speaker 7:
[30:03] Right.

Speaker 1:
[30:04] But if you look at vaping just on its own, vaping looks bad. And so the reason that we have been making this comparison is because vaping was brought on the scene as this tool to help people quit smoking. So it's very important for you to know as a smoker, wait, should I switch to this healthier thing or not?

Speaker 7:
[30:28] Yes, that's what I was trying to say earlier.

Speaker 1:
[30:30] Which leads us to our next question, which is, how well do vapes actually help people quit smoking?

Speaker 12:
[30:38] It's actually a really tiny number of people who successfully quit smoking using vapes.

Speaker 1:
[30:43] Here's Becky Freeman again, the public health researcher.

Speaker 12:
[30:46] Even in the best clinical trials, it's about 10 percent. So it's a 90 percent failure rate, right? This is not a miracle cure. This is not some sort of tech bro solution to the smoking epidemic that we have.

Speaker 7:
[31:00] Wow. I'm surprised it's that small.

Speaker 12:
[31:02] Yeah.

Speaker 1:
[31:03] So that number comes from a Cochrane review, which pulled together a ton of trials, looking at thousands of people and ultimately concluded that for every 100 folks who use nicotine e-cigs to stop smoking, eight to 11 of them might successfully stop, which is where you get that 90 percent failure rate. It's worth pointing out, according to that review, vapes don't look too bad when you compare it to the other stuff. So six out of 100 people might successfully quit smoking when they use patches or gum. Four out of 100 might successfully quit if you do other things, like you go cold turkey. If you were surprised that it doesn't work that well, how come?

Speaker 7:
[31:46] Well, I know a couple of people who have quit smoking and vape instead. In general, I feel like I've seen that work, but I think also I didn't know that the other methods were so bad.

Speaker 1:
[31:59] But here is why, because I can hear people really holding on to this, particularly if you want to keep holding on to your vapes. Here is why experts will say, try all that other stuff first before going for vapes. One is, well, let's say if you're just using patches, you are not breathing in that vape crap. But also, because people who use vapes to quit smoking, like the friends in your life, keep vaping. They then pick up the habit.

Speaker 7:
[32:37] Keep smoking?

Speaker 1:
[32:38] No, they keep vaping. They pick up the habit of vaping.

Speaker 7:
[32:43] They become vapers, yeah.

Speaker 1:
[32:44] Whereas people who use patches, gum, stuff like that, they eventually manage, they've got a much higher chance of quitting their dependency altogether. So for example, one randomized control trial found that 80 percent of the people who quit cigarettes using vapes were still vaping a year later, 80 percent.

Speaker 7:
[33:05] Right.

Speaker 1:
[33:06] While only nine percent of those who did stuff like patches and gums, were still using those products.

Speaker 7:
[33:13] You know what's so funny? I wasn't even thinking of the fact that you're supposed to stop vaping. I don't know anyone that's stopped vaping.

Speaker 1:
[33:19] I know. I know. But, okay, so here's where we are at. Most scientists agree that vaping is safer than smoking. And that means that if you are a smoker and you want to quit, vaping may help you. But for all the reasons we just talked about, try using other stuff first, like gum, like patches. Yeah.

Speaker 7:
[33:46] And I guess like if we're wondering, why are we comparing vaping to smoking? In 2026, it's not even relevant for a ton of people. They aren't vaping to quit smoking, they're just vaping to vape, right?

Speaker 1:
[33:58] Well, yeah, exactly. I mean, one survey of thousands of Americans found that over half of established vaping young adults never regularly smoked. So if that's you, I mean, who cares if vaping is safer than smoking, right? And now we have a new generation of people addicted to vaping. And in fact, Becky Freeman does this study where her and her colleagues will talk to thousands of young people. And she has actually seen vaping go from this fuzzy thing to a full-blown addiction.

Speaker 12:
[34:38] A few years ago, when we first started this research, young people were like, oh, vaping is fun. It's something I do socially on the weekend. It's no big drama. And then over the years, it's become more of, I'm so addicted, I need to vape in the middle of the night. I can't go a day at work without having a vape. I try leaving in my car and all I do is think about it.

Speaker 1:
[34:56] So vaping bad for you, smoking worse for you, also bad for you. But there's still so much doubt and confusion in the public, I think, to our listeners. And I am wondering if at least part of that is thanks to Big Tobacco being up to their old tricks again.

Speaker 7:
[35:21] Is this the conspiracy theory portion of the episode?

Speaker 1:
[35:24] Maybe, maybe, but hear me out, okay? The major international tobacco companies own many of the top vaping brands, right?

Speaker 7:
[35:34] Yes.

Speaker 1:
[35:35] Okay. And it is well documented that Big Tobacco wrote the playbook on spreading misinformation. It is the playbook that Big Oil reads to spread misinformation about climate change. And so one of the key tactics that they learned really early on is so effective at allowing them to keep selling their cigarettes in the face of all this science about lung cancer is using doubt. Are the scientists sure about what is going on? In this case, we can see doubt all through this episode, right?

Speaker 6:
[36:14] How vapes that bad?

Speaker 1:
[36:16] Yeah.

Speaker 7:
[36:17] The study had this issue. Yeah.

Speaker 1:
[36:20] Creating doubt amongst science is so damn easy, right? Because well-meaning scientists will nitpick at each other's research to get to the truth, making it so handy for big vape to say, look, the scientists are fighting.

Speaker 7:
[36:36] Yeah.

Speaker 1:
[36:36] Let's just keep vaping until they work it all out.

Speaker 6:
[36:40] Yeah.

Speaker 7:
[36:40] You know?

Speaker 1:
[36:42] But of course, in the playbook, it's not just about leaning on down to sell your product. Big tobacco is also actively funding science, and a lot of that science helps their cause. So, for example, today you can find the Foundation for a Smoke Free World, whose goal is the end of tobacco use achieved through funding research and promoting innovation.

Speaker 6:
[37:12] What could create a smoke free world, but a vape filled world?

Speaker 7:
[37:18] Well, that's bleak.

Speaker 1:
[37:20] They are entirely, entirely funded by big tobacco. Just a couple of years ago, they changed their name, by the way, to Global Action to End Smoking. This is just one of these groups. Other companies that sell these products are out there funding science too.

Speaker 7:
[37:43] Wow. Dang. Do you think this really corrupts the majority of this research? How big of a problem is this? Yes.

Speaker 1:
[37:50] That is what I wanted to know. Okay. Around 10 years ago, a researcher in Denmark did one of the first systematic reviews on the health effects of e-cigarettes, which looked at almost 100 studies. Then she analyzed all the conflicts of interest. Do you want to guess what percentage of the studies had some industry conflict of interest?

Speaker 7:
[38:13] 50 percent?

Speaker 1:
[38:15] It was 35 percent.

Speaker 7:
[38:16] Okay. That's still pretty high.

Speaker 1:
[38:18] There's other studies that have looked at this problem in slightly different ways. They find that maybe it's one in four, so 24 percent had disclosed industry funding. Which one in three, one in four studies in this space are industry funded. I mean, it's not good. Of course, unsurprisingly, research shows that studies that are industry funded in this space are more likely to say things like vaping is either harmless or be pro-vaping more generally. So you say things like, wow, they look pretty good compared to cigarettes.

Speaker 7:
[38:58] That makes me think of that paper that we talked about, about like, vaping is just as bad as smoking when it comes to heart stuff. Then I was like, it got a lot of critique and criticism. Some of it quite feisty, actually. I did look at some of the declarations, conflicts of interest, and about something like half the responses that I found declared at least some kind of tie to tobacco or getting some funding or some money from a tobacco or vape company. So I've seen it too.

Speaker 1:
[39:29] Yeah. I mean, by the way, more than 90% of the people that we surveyed in our little Science Vs. survey, they didn't get any industry funding, not even from pharmaceutical companies. I also talked to Becky about big tobacco and how it's muddying the waters here and here's what she said.

Speaker 12:
[39:49] There is a lot of misinformation that benefits the bottom line of transnational companies that we're also up against. My budget, the health department's budget, pales in comparison to that of big tobacco and big vape.

Speaker 1:
[40:03] You know, in meanwhile, we are getting more and more evidence that vaping on its own is bad, right? Even if it, we don't know if it causes cancer yet, we know it messes with your lungs, we know it increases your risk of asthma, we know it makes it more likely that you'll cough or wheeze, more and more evidence showing it's not good for your heart.

Speaker 7:
[40:21] Well, Wendy, that is a real bummer. So thanks, I guess. I'm sorry.

Speaker 6:
[40:27] But the good news is that there's a, you know that song that we played for people that we didn't lie to them with? The end of it is really quite prescient. And so, do you want to hear it?

Speaker 7:
[40:44] Yeah, let's, we'll play me out. The prophecy came true.

Speaker 1:
[41:01] The prophecy came true. John asked me how many citations are in this episode.

Speaker 7:
[41:13] So Wendy, how many citations are in this episode?

Speaker 1:
[41:16] There's 78.

Speaker 7:
[41:17] Thanks so much for telling me.

Speaker 6:
[41:22] The people want to see them. They can go to our show notes. There's a link to the transcript.

Speaker 1:
[41:27] You can read them in all their glory.

Speaker 7:
[41:29] Thank you, Rose. Thanks, Wendy.

Speaker 1:
[41:32] If you're thinking of switching to They've Been, do it. Probably try gum or patches first. That's my kazoo.

Speaker 7:
[41:44] You said it was your kazoo, but you made emotion like it was a trombone. What do you think a kazoo is?

Speaker 1:
[42:06] Science Vs. is a Spotify Studio's original. Listen to us for free on Spotify, or wherever you get your podcasts. If you are listening on Spotify, you can follow us and tap the bell icon so you get episode notifications. If you like this show, give us a five-star review, write a comment, say hello. This episode was produced by me, Wendy Zukerman, and Rose Rimler, with help from Ekedi Fausther-Keeys, Meryl Horn and Michelle Dang. We're edited by Blythe Terrell. I'm the executive producer. Fact-checking by Erica Akiko Howard, mix and sound design by Bobby Lord, music written by Bumi Hidaka, Peter Leonard, Emma Munger, and Bobby Lord. Thank you so much to the Australian Science Media Centre for all your help with this episode. Also, thank you to the scientists who responded to our emails on this. Oh my gosh, some of you wrote the most lovely and thoughtful emails. We really appreciate you responding to us. A big thanks to Joseph Lavelle Wilson and the Zukerman family. I'm Wendy Zukerman. Back to you next time. You know, it's kind of like, do you need to watch seven seasons of Young Sheldon or Star Wars The Phantom Menace?

Speaker 7:
[43:19] Wait, which, in that analogy, which is vaping and which is smoking?

Speaker 1:
[43:23] I think the more painful is Young Sheldon, because seven seasons.

Speaker 6:
[43:28] Either way, you don't have to do, you could do other things with your time.

Speaker 1:
[43:31] You don't need to do either, is the point.

Speaker 7:
[43:33] Yeah, point extremely clearly made. I can't think of a better public health message than that.

Speaker 6:
[43:40] Would it help if I said, Misa, no need to.

Speaker 7:
[43:45] It wouldn't help actually.

Speaker 12:
[43:54] You know what?

Speaker 1:
[43:55] Becky Freeman has actually watched as...

Speaker 7:
[43:57] Watched all seven seasons of Young Sheldon?

Speaker 6:
[44:04] I'm trying to make a serious point here!