A Switch to Vaping Reduces 8 Biomarkers of Smoking As Much As Abstinence

A randomized clinical study adds to the evidence that e-cigarettes are far less hazardous than the conventional kind.


Juul Labs

A randomized clinical study that was discussed at a conference on Saturday found that smokers who switch to Juul e-cigarettes see the same reductions in biomarkers of exposure to hazardous chemicals as smokers who quit without vaping. The study, sponsored by Juul Labs as part of the documentation it will need for the Food and Drug Administration's approval to keep its products on the market, provides further evidence that vaping dramatically reduces the health risks that smokers face.

The researchers randomly assigned 90 smokers to vape instead of smoking, to stop smoking without vaping, or to continue smoking. After five days, the urine and blood levels of eight biomarkers of exposure (BOEs) were reduced by 85 percent in the vaping group, compared to 85.3 percent in the abstinence group. The difference between the two groups was not statistically significant. BOE levels in the group that continued to smoke, meanwhile, were 14.4 percent higher than the baseline results (which were obtained from all subject after 12 hours of abstinence at the beginning of the study).

Juul Labs

"The equivalent reductions in these specific cigarette-related biomarkers across the groups who abstained from smoking and those who used JUUL products reaffirms the role vapor products can have for the adult smoker," Juul Labs CEO Kevin Burns said in a press release. "Although addictive, nicotine is not directly responsible for the cancers that are commonly associated with cigarette use; rather it is the harmful constituents that are present in combustible smoke. The more that can be done to eliminate cigarettes, the greater the impact will be on the public health. We are committed to conducting rigorous, scientific research as we contribute to the ongoing dialogue regarding vapor products, and look forward to sharing additional research with the medical, scientific, and public health communities."

Despite findings like these, anti-smoking activists and public health officials in the United States continue to imply that e-cigarettes are only a little less dangerous than the conventional kind, that the jury is still out on whether they are any safer at all, or even that they have been shown to be just as dangerous. Boston University public health professor Michael Siegel notes one recent example: The Pennsylvania Department of Health falsely claims that "e-cigarettes, also known as e-cigs, e-hookahs, mods, vape pens, vapes or ENDS, are not safer than other tobacco products for youth."

With such flat-out lies passing for medical advice, it is no wonder that Americans are confused about the relative hazards of smoking and vaping. In one survey, the share of adults who incorrectly said vaping is as harmful as or more harmful than smoking tripled between 2012 and 2015, from 13 percent to 40 percent. In a 2018 Harris poll, 43 percent of adults erroneously thought e-cigarettes are more harmful than the combustible, tobacco-containing kind. This kind of misinformation, to the extent that it discourages smokers from switching to vaping, can be deadly.

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  1. Looks like they didn’t measure the biomarker for douche levels.

  2. Vaping equipment supply vans will be the new food trucks.

  3. While I do not need to be scientifically convinced that e-cigarettes are a far better alternative to traditional cigarettes, I do wish this article would have gotten into the weeds a little more than it did. I, and I suppose most non-scientist reading this, do not know what is meant by a biomarker of exposure (BOE). What exactly is being measured? I often rely on this type of article to formulate arguments, but I cannot argue something that I don’t fully understand.

    1. It examined changes, relative to baseline, in primary urine and blood BOEs in 90 adult smokers. The selected short-term biomarkers, NNN, NNAL, 3-HPMA, MHBMA, S-PMA, HMPMA, CEMA, 1-OHP, and COHb, are carcinogens observed in the use of combustible cigarettes, and are widely recognized as contributing to tobacco-related cancers.

      1. Thank you for that information. So an accurate and informative headline would be “A switch to vaping reduces exposure to carcinogens”. That was just what I expected, since the source of most of the carcinogens is the smoldering fire and not the tobacco itself.

  4. The Pennsylvania Department of Health falsely claims that “e-cigarettes, also known as e-cigs, e-hookahs, mods, vape pens, vapes or ENDS, are not safer than other tobacco products for youth.”

    Perhaps the DoH means “not safer” in the sense “the authorities will bust your minor ass for any of this stuff”.

  5. Vaping causes climate change.

    If it doesn’t stop, the world will end in 12 years !

    1. If cows vaped, would they fart less?

  6. Reason needs to stop publishing science based articles because they are absolutely moronic and really destroy any potential positive reputation for this site. Nicotine (and all the other shit you get from smoking) is deadly no matter what delivery system is used. Suggesting that e-cigs aren’t bad for you just because real cigarettes are that much worse is the relativist fallacy at its worst. You’re not a doctor. You don’t know any doctors. Any doctor will tell you that the chemicals generated by vaping are carcinogens and they’re not good for your health. We’re all libertarians here and we all support the freedom to poison yourself, but for the love of god, stop peddling fake science. Focus on the principles. People should be allowed to vape even if it killed them in an instant.

    1. Right, there is absolutely no value in knowing the relative risks of different things. And all doctors agree completely about everything you said, I’m sure.

      1. Relative risk is only valuable when provided accurately. Equating vaping with abstinence is 100% false and a pathetic excuse for science. There is absolutely no comparison between not smoking at all and inhaling nicotine and other carcinogens on a regular basis.

        I don’t know why so many people here peddle conspiracy theories about doctors, but if you intimately know a bunch of them (I have several in my family) and they all agree on the science, it’s sort of hard to cherrypick. It’s kind of like that JRE podcast with the weed doctor who is in family practice for

        1. less than 5 years and he literally sells weed as part of his business. Of course you can find one doctor who agrees with your anti-factual lunacy. There’s always one of everything. That’s why that type of argument is called cherry picking.

    2. “Nicotine (and all the other shit you get from smoking) is deadly no matter what delivery system is used.”

      sure, sounds legit. Maybe you should ask all your doctor friends if they prescribe NRT? And if so, why are they deliberately poisoning their patients?

    3. Your John Stewart Mill libertarianism is to be commended but not so the appeals to authority nor the anti-smoker belief system that preaches “Nicotine (and all the other shit you get from smoking) is deadly”. The health and cognitive benefits that nicotine endows on its users are many and varied. Have you never wondered why ‘they’ want prohibit tobacco/vaping or reduce/eliminate nicotine in vape juice or retail tobacco YET spend a fortune on advertisements to sell pharma nicotine gums, patches, mouth sprays etc.? The potential profit in medicinal nicotine could be phenomenal – all ‘they’ have to do is eliminate the competition in delivery mechanisms such as the simple organic cigarette!

      Any priest will show you the evidence of the existence of God. How many will deny the existence of God? Doctors have been subjected to far more anti-smoker propaganda than the average member of the public – take that into account when you say “any doctor will tell you …(eg. smoking is bad)”!

      Many Doctors do NOT agree with anti-smoker propaganda. Here’s just one; Dr G Segura, (Nicotine – The Zombie Antidote);

      “I’m sick and tired of the anti-smoking culture that has taken over the entire world. I have had enough of hearing “don’t smoke, it’s bad for you!!” The ignorance that betrays such remarks is utterly abysmal, especially coming from people who should know better…You have no idea how many times we have found again and again the protective properties of tobacco smoking.”

  7. I’d be more comfortable with the results if the study was not paid for by Juul. The cigarette companies fought the claim that smoking caused cancer for 50 years.

  8. I am earn with Google, Im making over $2000 a month operating low maintenance. I kept listening to extraordinary humans find to me how an awful lot money they can make on-line so I tested it. everything thought of it as, became all considerable and has definitely changed my lifestyles. For more records go to below site..

  9. Start working at home with Google! It’s by-far the best job I’ve had. Last Wednesday I got a brand new BMW since getting a check for $6474 this – 4 weeks past. I began this 8-months ago and immediately was bringing home at least $77 per hour. I work through this link, go to tech tab for work detail.

  10. Sorry guys, but this is just another variation on a Zohnerism.

    Biomarkers are just a measurement tool like that which tells you how much alcohol-by-volume is in the beer you drink, what vitamins are in your corn flakes or the tape measure that tells you how long that piece of wood is etc. It may well tell you that smokers have more/less of xxx or yyy biomarkers and that some of those biomarkers are deemed to be carcinogenic but it does NOT tell you whether xxx or yyy are actually bad, good or make no difference whatsoever to health – that is where assumptions, value judgments, opinions and bias come into it. Extensive scientific research using whole smoke, over decades, has failed to show any deleterious effects.

    ‘The poison is in the dose’ is relevant; Many things we eat, drink, smoke, breathe in, can be harmful in large quantities but beneficial to health in smaller quantities. eg. Think Warfarin- a rat poison that helps many people with heart problems or Vaccines that introduce live but attenuated viruses into the bloodstream to induce an autoimmune response to protect against any future infection.( Look at Hormesis or the Hygiene hypothesis.)

    Smokers probably do have ‘stuff’ in their bodies that non smokers do not – why else are Lungs donated by smokers for transplant more effective that those from non smokers? Why else do smokers live longer with sharper brains than non smokers according to most longevity research etc?

  11. It’s important to note that the real attack is generally NOT coming from a rational scientific base, but rather from the psychologically / situationally locked views of various types of Antismokers.

    To see what I mean, Google “Recognising Anti-Smoking Types” and read the short summary in Signs Of The Times while considering how those “types” relate to vaping today. Even “The Innocent” have been roped into opposing vaping by the money-driven media outreach of Antismokers they’ve been convinced that the two activities, vaping and smoking, and their (by)products, are one and the same.

    Look at how the NY Times and other outlets helped move the concept of “Thirdhand Smoke” from being a late-night comedy joke to a money pie that’s had millions of dollars pumped into it in an effort to plant mind-worms of fear in people out of virtually nothing.

    This research on Biomarkers is important… but it’s not enough. Unless the craziness at the base of so much of the antismoking and antivaping movements exposed and discredited, the science alone will never be enough.

    – MJM, who’s actually just emerged from a lengthy discussion regarding “Third Hand Vapor” and someone worried about TSNAs created on his clothing when around vapers. (And no, as usual with these things, I’m not joking.)

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