Equating Vaping With Smoking Is Medical Malpractice

Celebrity doctor Margaret Cuomo falsely claims e-cigarettes are "at least as harmful" as the real thing.


Like most professional pundits, Margaret Cuomo has perfected the art of speaking authoritatively even when she does not know what she is talking about. Unlike most professional pundits, Cuomo is in a position to cause real damage. As a celebrity doctor spreading misinformation about the hazards of vaping, she is actively discouraging smokers from making a switch that could save their lives, thereby undermining her avowed goal of A World Without Cancer.

That's the title of a book that Cuomo, a radiologist who is the sister of New York Gov. Andrew Cuomo and CNN anchor Chris Cuomo (as well as the daughter of former Gov. Mario Cuomo), published in 2012. Given Cuomo's medical degree and her experience in diagnosing and writing about cancer, any layman unfamiliar with the subject would be inclined to believe her statement, in a Huffington Post video posted on March 14, that "e-cigarettes will raise your risk for lung cancer but also other cancers, like liver cancer." But as Boston University public health professor Michael Siegel (who is also a physician) was quick to point out, "there is absolutely no evidence to support this claim," which Cuomo retracted after The Daily Caller's Guy Bentley asked about it.

A new, hastily edited version of the video omits the cancer claim. Also gone: claims that tin has been detected in the aerosol produced by e-cigarettes and that vaping generates hazardous chemicals that are not found in tobacco smoke (which Siegel called "an outright lie"). But the corrected video still features a statement that sums up Cuomo's take on vaping. "Because of their chemical composition," Cuomo says as the video begins, "e-cigarettes are at least as harmful to your health as regular tobacco cigarettes are." A caption drives the point home: "They're not a safer cigarette." 

How does Cuomo know that? She doesn't, because it's not true. E-cigarettes, unlike the conventional kind, do not contain tobacco and do not burn anything, so they do not generate the 7,000 or so chemicals found in cigarette smoke, which include hundreds that are toxic or carcinogenic. While a few of those worrisome substances have been detected in e-cigarette vapor, they are present at much lower levels. According to a 2013 analysis of 12 brands that was reported in the journal Tobacco Control, "The levels of potentially toxic compounds in e-cigarette vapour are 9–450-fold lower than those in the smoke from conventional cigarettes, and in many cases comparable with the trace amounts present in pharmaceutical preparations."

A 2015 report from Public Health England emphasized the enormous difference in risk between e-cigarettes and the real thing. "While vaping may not be 100% safe," it said, "most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger. It has been previously estimated that [electronic cigarettes] are around 95% safer than smoking. This appears to remain a reasonable estimate."

Siegel thinks even that estimate, which means vapers face 5 percent the risk that smokers face, exaggerates the hazards of e-cigarettes. "Based on the evidence that's out there," he recently told The San Diego Union-Tribune, vaping is "much, much safer—orders of magnitude safer….My impression is that 5 percent is way too high. That would be about 20,000 deaths a year [if all smokers vaped instead], and I don't think that's feasible."

In short, there is no scientific basis for Cuomo's warning that "e-cigarettes are at least as harmful to your health as regular tobacco cigarettes are." Not surprisingly, she cites no evidence to support the claim, other than to mention four carcinogens (benzene, cadmium, nickel, and formaldehyde) that have been detected in e-cigarette vapor. She does not mention the tiny amounts involved, which are far lower than the amounts found in tobacco smoke (except in experiments that deliberately overheat vaporizers to produce unusually large amounts of formaldehyde), or that the list of problematic chemicals in tobacco smoke is much longer. Saying we know e-cigarettes are just as dangerous as tobacco cigarettes "because of their chemical composition" may sound scientific, but it's complete nonsense.

The Huffington Post amplified Cuomo's blatantly inaccurate warning with its original headline: "Doctor Explains Why E-Cigarettes Are Just As Dangerous As Tobacco Cigarettes." That headline can still be seen on the website, over a post that no longer includes the Cuomo video but does include a correction mentioning the three inaccurate statements that were excised from it. "There's a misconception that e-cigarettes may be a better alternative to tobacco cigarettes," the post says, "but according to Margaret Cuomo, the author of A World Without Cancer, the two are both dangerous." Even if two products are "dangerous," of course, one can still be much less dangerous than the other, as in this case.

The headline over the new version of the video is notably different from the original headline: "Why E-Cigarettes Are Dangerous to Your Health." That phrasing leaves open the possibility that e-cigarettes are nevertheless safer than conventional cigarettes—a possibility that Cuomo still denies in the opening line of the video. Her position in the original version could be ascribed to ignorance, which would be bad enough for someone presenting herself as an expert. But her decision to stick with it even after the error was called to her attention suggests something worse: either a deliberate attempt to mislead people or a desire to save face by pretending that her central thesis is still valid despite the misrepresentations she already has admitted. 

The Internet is full of people saying demonstrably wrong things about all sorts of subjects, including e-cigarettes (as Michael Siegel doggedly documents on his tobacco policy blog). But as a medical professional engaged in public education (or, in this case, miseducation), Cuomo has a special obligation to get things right. By stubbornly insisting that vaping is just as dangerous as smoking, she does a potentially deadly disservice to smokers who may decide, based on her advice, that they have nothing to gain from switching.

This article originally appeared at Forbes.com.

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  1. e-liquid? Really? That's what the sign says?

    Is this a common term that I've just overlooked due to not being a customer in that market?

  2. Weil, Phil, Ruth, Oz, and now Cuomo. These celebrity doctors seem to emphasize celebrity rather than "doctor."

    1. If they could hack it as doctors, they wouldn't have taken to the celebrity route.

    2. Dr. Oz is my absolute fave. Watching him squirm at his congressional hearing was delightful. I'm sure he can cry into his cash pile about it.

    3. Personally, as soon as I saw the word 'Cuomo', I flinched involuntarily from the expected nutpunch. At this point, all thinking people realize that the word Cuomo is Italian for 'pretentious, Progressive prick'.

  3. I'll probably never vape, but the people that get their hackles up when they see someone vaping are the same busybody pieces of shit that can't stand watching someone enjoy eating McDonald's, for exactly the same emotive feelz. "I don't get it, let's find a reason to ban it."

    1. enjoy eating McDonald's

      Does not compute.

      1. Not even fries?

        OK, strange space alien.

        1. No, Mr Lizard is the alien. I would have thought the "Does not compute" would imply a more electronic origin.

          1. I guess it didn't compute.

            1. Surprise! Surprise! A medical expert, that is caught spreading false information would rather lie to the public than admit they're intentionally misleading them!? It is probably a rule of thumb, for narcissists who think they are always right about everything. If she retained any knowledge about her organic chemistry in college...If she had any training at all about general medical knowledge involving lung disease...or the real complications of vaporizing glycerine products..the real risk with nicotine being cardiovascular disease (seen mostly when it is consumed through using tobacco products)...It is real difficult to believe anything this, so called "expert" really "knows"! Then again, most radiologists retain very little, when it comes to one on one patient care and evaluation. Everything needs to be researched and verified when there is so much controversy around a subject! Sadly, it is even more important, now, around such people who would rather save face by continuing a fabrication! I have found most of my colleagues think they have more education than the competitors. There is so much difference between GP-s certified to be FP doctors by grandfathering in. Some of them have one year internships, only, when embarking on their medical practices, although their numbers are dwindling.

              1. Even with that, many physicians may have had graduate school training prior to attending medical school. I can assure you, other doctors get real self conscious, when a better educated colleague, seems to have a better handle on the science of medicine! (only because they might have a couple, or more, years of extra education) Add to that petty medical politicians, and you have a medical community, that cares less about patient care than it does the intellect of their competition.

                1. This should have been made as a separate comment. But, came in the middle, here, for some unknown reason!

    2. They're neo-puritans. As Mencken said, they're afraid that someone, somewhere, is having fun.

  4. I find it annoying and will silently judge you. Doesn't mean I want it banned.

  5. It looks like smoking, so it must be bad.

    1. Where there's e-smoke there might be an e-fire

    2. The "big tobacco" companies have started moving into vaping and e-cigs, and "big tobacco" is bad, therefore vaping must be bad too.

      1. I think we may have the answer here. I don't recall the typical visceral lefty-hate for vaping BEFORE the tobacco companies got involved.

      2. I smoked cigarettes for 40 years and I was going through 2 cartons a week. I started vaping pretty much by accident, I was not trying to quit. Within a week I was basically done with smoke. The esmokes that big tobacco are hawking (Blues, etc.) are toys. They will not give a smoker the lung hit they crave. Been there, done that. But Brown & Williamson have very little reason to provide an incentive for people to quit buying cigs.
        Statistically 20% of the adult population will continue to smoke no matter how expensive or shameful the habit becomes. It's worth remembering that smoking, smoking prohibition, and smoking cessation schemes are a huge business. Direct taxes, the tobacco settlement (another tax), anti smoking propaganda, patches, gum, and prescription drugs generate billions for governments and businesses. Like Hilary explained about smoking prohibition's big brother, the WOD, you can't end it because there's too much money in it. If that 20% drops to 10% or 5% (a likely scenario) because smokers visit their local mom and pop vape shop, a whole lotta people are gonna be out of work. They haven't yet figured out how to keep the mules in the harness. There are moves to tax, regulate and prohibit vaping. We're already hearing specious claims about "2nd hand vape" and completely unsupported crap about vaping health risks from the POS Ms. Cuomo and others.
        Interesting read on the subject here: http://www.ecigarette-politics.....ctive.html

        1. Let me try that link again http://www.ecigarette-politics.....ctive.html

        2. As a reasonable person who converted from smoking to vaping, I think it's important to remain vigilant against the dangers of vaping (both real and potential).

          1: Rapid tooth loss - Low quality, damaged, and improperly charged batteries can explode.
          2: Cancer causing agents - Inhalation of a dry hit, where the wick or element is burned.
          3: Contaminants - No regulatory oversight of eLiquid ingredients, manufacture, or packaging.

          Those are the easy-to-solve issues we currently face. The more difficult issues to iron out are:

          4: Longterm exposure to high doses of inhaled PG/VG. (time will tell, studies look promising so far)
          5: Mouth/tooth/gum/throat related studies as related to eCigarettes.

          All we can do is wait and see, and do our best to contribute to the organizations conducting these studies.

          1. I'm all for more information. But when you call for "regulatory oversight of eLiquid ingredients, manufacture, or packaging" you're opening the door for exactly the prohibitionist crap I warned of above. The market will very quickly determine whether a product is worthy or not. Government intervention will only make the product more expensive and exclude competitive products from the market. But let's take a look at your concerns.
            1. Exploding batteries. My TV remote could explode and cause rapid finger loss.
            2. Dry hits? Seriously, how many people are going to put up with that long enough to develop cancer. And, by the way, life causes cancer. If you live long enough, you're gonna get it.
            3. Yeah,better get the government involved otherwise "big juice" will be free to poison everybody.
            4. Gotta be better than smoke.
            5.See 4. above
            You are correct that some worthy organizations are studying the effects of vaping and that we should support their efforts. You are incorrect in believing that government will protect your interests by regulating vaping. That's not how government works. Government perpetuates itself. Nothing more nothing less. Government doesn't give a rat's ass about you.

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  7. E-cigarettes, unlike the conventional kind, do not contain tobacco and do not burn anything, so they do not generate the 7,000 or so chemicals found in cigarette smoke, which include hundreds that are toxic or carcinogenic.

    But it's all those electrons in the stream the vaper is inhaling. Who knows what they can do to your lung atoms.

    1. I'm sure it will be a net negative effect.

  8. Another Cuomo with problems telling the truth.

  9. I dont get the whole "vaping" thing.


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  13. I don't really care what drug warriors like Cuomo say, especially since she is more celebrity than respected physician.

    I smoked for 25 years, Marlboro reds, and picked up vaping a week ago. I have not smoked a cigarette since. (I actually threw out the rest of my carton yesterday after church). I also have a plan to reduce my 12mg juice to 6mg in a few weeks, and eventually to nothing, after which I'll stop vaping altogether.

    Is vaping totally safe? Of course not. But for many (including me) it helps to quit smoking.

    But if someone choose to do either (smoke or vape) for as long as they want, it should be their decision. It's not cool to blow fumes or what not in people's faces, but yeah.

  14. The US medical establishment also used to consider homosexuality to be a mental illness listed as such in the DSM until 1980. Same goes now for vaping, or any behavior that looks like smoking. Its really about their bottom line though, you must quit their way with nicotine gums, patches, or pills, dammit!

  15. They're also kind of afraid people will use the e-cigs to smoke marijuana or crack and no one would be the wiser.

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  17. The fact that the "anti-smoking" brigade objects to this safe alternative belies all their handwringing about the health effects of actual smoking. They are much more motivated by making the world a better place for them to live in by stopping a legal behavior of which they simply do not approve.

    1. You sir, are correct.

  18. The best (abstinence) is the enemy of the good (harm reduction).

    Best-ists are the bane of humanity.

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